Provider Demographics
NPI:1043427081
Name:ORR, DANIELLE J (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:ORR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:J
Other - Last Name:ORAVECZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10025 OLD OCEAN CITY BLVD
Mailing Address - Street 2:BUILDING ONE
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811
Mailing Address - Country:US
Mailing Address - Phone:410-208-9761
Mailing Address - Fax:410-208-9764
Practice Address - Street 1:11107 RACETRACK RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-3279
Practice Address - Country:US
Practice Address - Phone:410-208-9761
Practice Address - Fax:410-208-9764
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0067227207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD415734600Medicaid
DE1043427081Medicaid
MD415734600Medicaid