Provider Demographics
NPI:1649386137
Name:O'MALLEY, ARAN (MD)
Entity type:Individual
Prefix:DR
First Name:ARAN
Middle Name:
Last Name:O'MALLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8515 BROWNES POND LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8669
Mailing Address - Country:US
Mailing Address - Phone:980-819-9127
Mailing Address - Fax:
Practice Address - Street 1:901 WEST MEETING ST
Practice Address - Street 2:SUITE 104
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-6219
Practice Address - Country:US
Practice Address - Phone:803-285-3700
Practice Address - Fax:803-285-3715
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95778207X00000X
SC30115207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC571029311005OtherBCBS
SC301159Medicaid
SCOTH000Medicare UPIN