Healthcare Provider Details

I. General information

NPI: 1043427081
Provider Name (Legal Business Name): DANIELLE J ORR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE J ORAVECZ MD

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11107 RACETRACK RD
BERLIN MD
21811-3279
US

IV. Provider business mailing address

10025 OLD OCEAN CITY BLVD BUILDING ONE
BERLIN MD
21811
US

V. Phone/Fax

Practice location:
  • Phone: 410-208-9761
  • Fax: 410-208-9764
Mailing address:
  • Phone: 410-208-9761
  • Fax: 410-208-9764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0067227
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: