Organization
MMG 1PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEX A TORRES (BILLING MANAGER)
(703) 684-4581
Entity
Organization
Contact information
Practice address
28000 JOY RD, LIVONIA, MI 48150-4137
(734) 513-8050
(734) 513-6357
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
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110163653
RAILROAD MEDICARE
GA
05
—
343393810
—
MI
01
—
700F314390
BCBS MI
MI
Enumeration date
03/31/2007
Last updated
09/20/2018
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