Provider Demographics
NPI:1265456503
Name:DONALD, ORLAND EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ORLAND
Middle Name:EDWIN
Last Name:DONALD
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 1:32 QUAIL RUN RD
Mailing Address - Street 2:
Mailing Address - City:STORRS MANSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06268-2768
Mailing Address - Country:US
Mailing Address - Phone:860-456-9443
Mailing Address - Fax:860-456-9443
Practice Address - Street 1:112 MANSFIELD AVE
Practice Address - Street 2:WINDHAM HOSPITAL EMERGENCY DEPT
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-2041
Practice Address - Country:US
Practice Address - Phone:860-456-6715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031284207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT930001529Medicare PIN
CTE70867Medicare UPIN
CTP00771208Medicare PIN