Healthcare Provider Details

I. General information

NPI: 1326114927
Provider Name (Legal Business Name): ROBERT C. ORR DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22821 ORCHARD LAKE RD
FARMINGTON MI
48336-3230
US

IV. Provider business mailing address

22821 ORCHARD LAKE RD
FARMINGTON MI
48336-3230
US

V. Phone/Fax

Practice location:
  • Phone: 248-615-6600
  • Fax: 248-615-6605
Mailing address:
  • Phone: 248-615-6600
  • Fax: 248-615-6605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number5101005472
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: