Mmg 1 Pc

LBN: Mmg 1 Pc
Mmg 1 Pc is an health care organization with primary practice located at 28625 Northwestern Hwy Suite 213, Southfield MI 48034-1828. The organization recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as the primary health care specialty. Mmg 1 Pc can be contacted via phone (248) 354-9666, or through Trivax, Geoffrey A via phone (313) 538-3099.

Contact Information

Primary practice address
28625 Northwestern Hwy Suite 213 Southfield MI 48034-1828
Phone: (248) 354-9666
Fax: (248) 354-3653
Website:
Map and Directions
Authorized official contact:
Name: Trivax, Geoffrey A Doctor of Medicine (MD)
Phone: (313) 538-3099

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X

Profile Details

NPI number 1023037025
LBN Legal business name Mmg 1 Pc
DBA Doing business as
Authorized official Trivax, Geoffrey A Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 19th, 2006
Last updated May 24th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023037025 NPPES
Michigan Other 500F318990 BLUE SHIELD GROUP

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