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Organization
MMG 1 PC
Active
Organization
MMG 1 PC
Active
Other names
INTERNAL MEDICINE PHYSICIANS, MILLENIUM DIAGNOSTIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEOFFREY A TRIVAX MD (PRESIDENT)
(313) 538-3099
Entity
Organization
Contact information
Practice address
30840 NORTHWESTERN HWY, SUITE 300, FARMINGTON HILLS, MI 48334-2552
(248) 932-8725
(248) 932-8977
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
(248) 851-1434
(248) 851-5182
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
NULL
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Enumeration date
07/12/2006
Last updated
12/23/2021
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