MMG 1PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MMG 1PC

Practice address

28625 Northwestern Hwy Ste 100
Southfield, MI 48034-8351

Phone

(248) 354-0730

Fax

(248) 354-1652

NPI assigned

Aug 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Geoffrey A Trivax, M.D.

Title

President

Phone

(248) 354-9666

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

MMG 1PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• MMG 1 PC

  dba Millennium Diagnostic Center

  • Diagnostic Radiology Physician
  • Farmington Hills, MI
  • NPI 1285873430
  NPD tax ID
• MMG 1PC

  dba Neurological Consultants

  • Neurology Physician
  • Southfield, MI
  • NPI 1184878001
  NPD tax ID
• MMG 1PC

  dba Northwest Internal Medicine

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1215103940
  NPD tax ID
• MMG 1PC

  • Internal Medicine Physician
  • Livonia, MI
  • NPI 1881714723
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey F Parker, M.D.

  • Internal Medicine Physician
  • Eureka, CA
  • NPI 1689650889
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1215040506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29992 NORTHWESTERN HWY STE C",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343292",
            "telephone_number": "248-851-1430",
            "fax_number": "248-851-5182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28625 NORTHWESTERN HWY STE 100",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480348351",
            "telephone_number": "248-354-0730",
            "fax_number": "248-354-1652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG 1PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "TRIVAX",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-354-9666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "110F375070",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MLK USA, LLC
• Christine Mlynarek, M.D.
• MM Medical Equipment,LLC
• MMG 1 PC
• MMG 1PC (Neurological Consultants)
• MMG 1PC (Northwest Internal Medicine)
• MMG 1PC (Associated Rheumatology Consultants)
• MMG 1PC (Premier Internists)
• MMG 1PC (Millenniun Physical Therapy Center)
• MMS Care PLLC (Mobile Medical Support)

• Internal Medicine Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.