Trivax, Justin Elijah

Trivax, Justin Elijah is an individual health care provider with primary practice located at 31500 Telegraph Rd Suite 115, Bingham Farms MI 48025-4367. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Trivax, Justin Elijah can be contacted via phone (248) 594-4913.

Contact Information

Primary practice address
31500 Telegraph Rd Suite 115 Bingham Farms MI 48025-4367
Phone: (248) 594-4913
Fax: (248) 594-4928
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301081886 Michigan
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 4301081886 Michigan

Profile Details

NPI number 1174566095
LBN Legal business name Trivax, Justin Elijah
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Dec 20th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174566095 NPPES
Michigan MEDICAID 1174566095
Michigan Other 700H273300

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