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Organization

MMG 1PC

Active
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Organization

MMG 1PC

Active
Other names
NEUROLOGICAL CONSULTANTS
Organization subpart
No

Provider details

NPI number
Authorized official
DR. GEOFFREY A TRIVAX MD (PRESIDENT)
(248) 851-1430
Entity
Organization

Contact information

Practice address
26400 W 12 MILE RD, SUITE 170, SOUTHFIELD, MI 48034-1700
(248) 208-8787
(248) 208-8788
Mailing address
29992 NORTHWESTERN HWY STE C, FARMINGTON HILLS, MI 48334-3292
(248) 851-1430
(248) 851-5182

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary

Other

Enumeration date
11/05/2008
Last updated
09/20/2018
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