Provider Demographics
NPI:1609910744
Name:NILDA D ORZAME MD PLLC
Entity Type:Organization
Organization Name:NILDA D ORZAME MD PLLC
Other - Org Name:WATERVLIET CLINICARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NILDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ORZAME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-463-4800
Mailing Address - Street 1:3881 NORTH M-140 HWY
Mailing Address - Street 2:
Mailing Address - City:WATERVLIET
Mailing Address - State:MI
Mailing Address - Zip Code:49098
Mailing Address - Country:US
Mailing Address - Phone:269-463-4800
Mailing Address - Fax:
Practice Address - Street 1:3881 NORTH M-140 HWY
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:MI
Practice Address - Zip Code:49098
Practice Address - Country:US
Practice Address - Phone:269-463-4800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101666977Medicaid
MI101666977Medicaid
MI0P61690Medicare PIN