# MMG 1 PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MILLENIUM DIAGNOSTIC CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912933540
- **Authorized official:** DR. GEOFFREY A. TRIVAX M.D. (PRESIDENT)
- **Authorized official phone:** (248) 851-1430

## Contact information

- **Practice address:** 32255 NORTHWESTERN HWY STE 100, FARMINGTON HILLS, MI 48334-1573
- **Practice address phone:** (248) 945-0000
- **Practice address fax:** (248) 945-1819
- **Mailing address:** 29992 NORTHWESTERN HWY, SUITE 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 |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RC0000X | Cardiovascular Disease Physician | — | NULL | — |
| 207RC0000X | Cardiovascular Disease Physician | — | — | — |
| 207RH0003X | Hematology & Oncology Physician | — | NULL | — |
| 207RH0003X | Hematology & Oncology Physician | — | — | — |
| 207RM1200X | Magnetic Resonance Imaging (MRI) Internal Medicine Physician | — | NULL | — |
| 207RM1200X | Magnetic Resonance Imaging (MRI) Internal Medicine Physician | — | — | — |
| 207UN0901X | Nuclear Cardiology Physician | — | NULL | — |
| 207UN0901X | Nuclear Cardiology Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 12/23/2021