Basic Information
| Provider Information | |||||||||
| NPI: | 1467495812 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORWICK | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8100 | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973030900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033992424 | ||||||||
| FaxNumber: | 5033757429 | ||||||||
| Practice Location | |||||||||
| Address1: | 2020 CAPITOL ST NE | ||||||||
| Address2: | |||||||||
| City: | SALEM | ||||||||
| State: | OR | ||||||||
| PostalCode: | 973033244 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033992424 | ||||||||
| FaxNumber: | 5033757429 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2006 | ||||||||
| LastUpdateDate: | 05/27/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MC260901 | OR | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | CS4159 | 01 | RAILROAD GROUP | OTHER | 260901 | 05 | OR | MEDICAID | 080047455 | 01 | RAILROAD MEDICARE | OTHER |