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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