Provider Demographics
NPI:1700854379
Name:ORLAN, RICHARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:ORLAN
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:PO BOX 165
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:VT
Mailing Address - Zip Code:05158-0165
Mailing Address - Country:US
Mailing Address - Phone:802-258-8677
Mailing Address - Fax:
Practice Address - Street 1:19 BELMONT AVE
Practice Address - Street 2:SUITE 1201
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-7109
Practice Address - Country:US
Practice Address - Phone:802-275-3640
Practice Address - Fax:802-275-3675
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME66475207RG0300X
NH8845207RG0300X
VT0420011566207RH0002X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1015520Medicaid
FL377156300Medicaid
FL377156300Medicaid
VT1015520Medicaid