MEDICARE: VIOLET HEALTH PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1003683137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIOLET HEALTH PC

Provider Business Mailing Address
First Line	:	2256 ORCHARD LAKE RD
Second Line	:
City	:	SYLVAN LAKE
State	:	MI
Zip	:	48320-1750
Country	:	US
Telephone Number	:	248-416-1499
Fax Number	:	248-971-1132

Provider Business Practice Location Address
First Line	:	2256 ORCHARD LAKE RD
Second Line	:
City	:	SYLVAN LAKE
State	:	MI
Zip	:	48320-1750
Country	:	US
Telephone Number	:	248-416-1499
Fax Number	:	248-971-1132

Authorized Official
Title or Position	:	OWNER
Name	:	JALAL THWAINEY
Credential	:	MD
Telephone Number	:	248-416-1499

Provider Enumeration Date	:	12/08/2023
Last Update Date	:	01/15/2026

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Directions to “VIOLET HEALTH PC ” Practice Location

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