Healthcare Provider Details

I. General information

NPI: 1245311398
Provider Name (Legal Business Name): ORCHARDVIEW PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12250 THIRTY MILE RD
WASHINGTON TOWNSHIP MI
48095
US

IV. Provider business mailing address

1000 JOANNE CT
BLOOMFIELD MI
48302-2417
US

V. Phone/Fax

Practice location:
  • Phone: 248-760-0522
  • Fax: 248-282-5137
Mailing address:
  • Phone: 248-760-0522
  • Fax: 248-282-5137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number4301407335
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301407335
License Number StateMI

VIII. Authorized Official

Name: DR. PHILIP MICHAEL O'HALLORAN
Title or Position: MEMBER
Credential: M.D.
Phone: 248-760-0522