Provider Demographics
NPI:1588776819
Name:ORBANA, MYRNA P (MD)
Entity type:Individual
Prefix:
First Name:MYRNA
Middle Name:P
Last Name:ORBANA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1919 LAKE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-7830
Mailing Address - Country:US
Mailing Address - Phone:574-948-5070
Mailing Address - Fax:574-948-5493
Practice Address - Street 1:303 S NAPPANEE ST
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-2066
Practice Address - Country:US
Practice Address - Phone:574-296-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-085773207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036-085773OtherSTATE LICENSE
IN01078074AOtherSTATE LICENSE