Provider Demographics
NPI:1922076900
Name:ORLICK, JOSEPH BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRUCE
Last Name:ORLICK
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 1:674 BERKMAR CIR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1464
Mailing Address - Country:US
Mailing Address - Phone:434-220-7501
Mailing Address - Fax:434-220-9401
Practice Address - Street 1:674 BERKMAR CIR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1464
Practice Address - Country:US
Practice Address - Phone:434-220-7501
Practice Address - Fax:434-220-9401
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA44055207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC78318Medicare UPIN
110007771Medicare PIN