Provider Demographics
NPI:1770557621
Name:ORANGE, DAVID TODD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:TODD
Last Name:ORANGE
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 1:1518 8TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3206
Mailing Address - Country:US
Mailing Address - Phone:202-577-1617
Mailing Address - Fax:
Practice Address - Street 1:700 2ND ST NE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-8100
Practice Address - Country:US
Practice Address - Phone:202-577-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0436112085R0202X
VA01012381532085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010191645Medicaid
VA017770VI8Medicare ID - Type Unspecified
I39276Medicare UPIN