Provider Demographics
NPI:1730259607
Name:O'MALLEY, RICHARD ARTHUR (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ARTHUR
Last Name:O'MALLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:SUITE 311
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7735
Mailing Address - Country:US
Mailing Address - Phone:410-296-1467
Mailing Address - Fax:410-321-4945
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:SUITE 311
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7735
Practice Address - Country:US
Practice Address - Phone:410-296-1467
Practice Address - Fax:410-321-4945
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDDOO47625207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GO6696Medicare UPIN