Provider Demographics
NPI:1912307646
Name:ORLOV, VIRGINIA T (PA-C)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:T
Last Name:ORLOV
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:T
Other - Last Name:LOBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:443-481-5049
Mailing Address - Fax:
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:443-481-3400
Practice Address - Fax:443-481-6705
Is Sole Proprietor?:No
Enumeration Date:2014-08-29
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC05491363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical