Provider Demographics
NPI:1144267097
Name:ORWIG, DENNIS STEVEN (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:STEVEN
Last Name:ORWIG
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:P.O. BOX 6102
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94948-6102
Mailing Address - Country:US
Mailing Address - Phone:415-884-6418
Mailing Address - Fax:
Practice Address - Street 1:250 BON AIR RD
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-1702
Practice Address - Country:US
Practice Address - Phone:415-925-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG576362085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA300035763OtherRAILROAD MEDICARE
CA00G576360Medicaid
CAE24924Medicare UPIN
CAAR682TMedicare PIN
CAAR682SMedicare PIN
CAAR682XMedicare PIN
CAAR682ZMedicare PIN
CAAR682VMedicare PIN
CA00G576360Medicare PIN
CAAR682UMedicare PIN
CAAR682WMedicare PIN
CAAR682YMedicare PIN