Northwest Internal Medicine
LBN: Mmg 1Pc
Northwest Internal Medicine is an health care organization with primary practice located at 28625 Northwestern Hwy Suite 213, Southfield MI 48034-1828. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Mmg 1Pc can be contacted via phone (248) 354-9666, or through Trivax, Geoffrey A. via phone (248) 851-1430.
Contact Information
Primary practice address
28625 Northwestern Hwy Suite 213
Southfield MI 48034-1828
Phone: (248) 354-9666
Fax: (248) 354-3653
Website:
Authorized official contact:
Name: Trivax, Geoffrey A. Doctor of Medicine (MD)
Phone: (248) 851-1430
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X |
Profile Details
| NPI number | 1215103940 |
|---|---|
| LBN Legal business name | Mmg 1Pc |
| DBA Doing business as | Northwest Internal Medicine |
| Authorized official | Trivax, Geoffrey A. Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 2nd, 2008 |
| Last updated | Sep 20th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215103940 | NPPES |
| Michigan | Other | 700F322430 | BLUE CARE NETWORK |
| Michigan | Other | 700F322430 | BLUE CARE NETWORK |
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