Provider Demographics
NPI:1548899016
Name:O'CONNELL, PATRICK HARDING (DO)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:HARDING
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:42450 W 12 MILE RD STE 315
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3030
Mailing Address - Country:US
Mailing Address - Phone:248-513-4100
Mailing Address - Fax:248-513-4105
Practice Address - Street 1:42450 W 12 MILE RD STE 315
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-3030
Practice Address - Country:US
Practice Address - Phone:248-513-4100
Practice Address - Fax:248-513-4105
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI51010265122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry