Individual
DR. GEOFFREY TRIVAX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28625 NORTHWESTERN HWY, SUITE 213, SOUTHFIELD, MI 48034-1828
(248) 354-9666
(248) 354-3653
Mailing address
28625 NORTHWESTERN HWY, SUITE 213, SOUTHFIELD, MI 48034-1828
(248) 354-9666
(248) 354-3653
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301031978
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0635303
BCBS INDIVIDUAL
MI
01
—
103419
GREAT LAKES HEALTH PLAN
MI
01
—
110169407
RR MEDICARE
MI
05
—
1164407730
—
MI
01
—
700F314390
BLUE SHIELD
MI
01
—
B0531
M'CARE
MI
Enumeration date
12/07/2005
Last updated
02/17/2011
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