=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326020462
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RICHARD N ORINO M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2005
-----------------------------------------------------
Last Update Date | 04/15/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2511 OLD CORNWALLIS RD STE 200
-----------------------------------------------------
City | DURHAM
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27713-1869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-932-5700
-----------------------------------------------------
Fax | 919-933-6881
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19701 BETHEL CHURCH RD SUITE 103 BOX 183
-----------------------------------------------------
City | CORNELIUS
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28031
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 774-234-6111
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 55285
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 2019-02237
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------