Provider Demographics
NPI:1730180043
Name:ORD, ROBERT ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:ORD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7825 OLD LITCHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-6975
Mailing Address - Country:US
Mailing Address - Phone:410-379-0453
Mailing Address - Fax:410-706-4199
Practice Address - Street 1:650 W BALTIMORE ST
Practice Address - Street 2:SUITE 1401
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1510
Practice Address - Country:US
Practice Address - Phone:410-706-6195
Practice Address - Fax:410-706-4199
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD111811223S0112X
MDD0041559204E00000X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDAV44Medicare ID - Type Unspecified
MDF17157Medicare UPIN