# MMG 1 PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** INTERNAL MEDICINE SPECIALISTS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023043486
- **Authorized official:** DR. GEOFFREY A TRIVAX MD (PRESIDENT)
- **Authorized official phone:** (313) 538-3099

## Contact information

- **Practice address:** 5821 W MAPLE RD, SUITE 190, WEST BLOOMFIELD, MI 48322-2275
- **Practice address phone:** (248) 855-0407
- **Practice address fax:** (248) 855-1323
- **Mailing address:** 29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
- **Mailing address phone:** (248) 851-1430
- **Mailing address fax:** (248) 851-5182

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/12/2006
- **Last updated:** 05/24/2021