Provider Demographics
NPI:1760476980
Name:O'MALLEY, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:O'MALLEY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:40 OKATIE CENTER BLVD S STE 100
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29909-7519
Mailing Address - Country:US
Mailing Address - Phone:843-705-8888
Mailing Address - Fax:843-705-7024
Practice Address - Street 1:40 OKATIE CENTER BLVD S STE 100
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29909-7519
Practice Address - Country:US
Practice Address - Phone:843-705-8888
Practice Address - Fax:843-705-7024
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2012-11-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC33229207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC332296Medicaid
SCAA65339192Medicare PIN