Provider Demographics
NPI:1124156575
Name:ORR, MICHAEL WAYNE (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:ORR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 ROSEMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4032
Mailing Address - Country:US
Mailing Address - Phone:301-698-8282
Mailing Address - Fax:301-698-8788
Practice Address - Street 1:4 PROFESSIONAL DR STE 139
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3426
Practice Address - Country:US
Practice Address - Phone:301-926-2228
Practice Address - Fax:301-926-3342
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01886111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD01886OtherSTATE LISCENSE #