<Unavail>
LBN: Mmg 1Pc
<Unavail> is an health care organization with primary practice located at 31500 Telegraph Rd Suite 100, Bingham Farms MI 48025-4367. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
Mmg 1Pc can be contacted via phone (248) 723-5880, or through Trivax, Geoffrey A via phone (313) 538-3099.
Contact Information
Primary practice address
31500 Telegraph Rd Suite 100
Bingham Farms MI 48025-4367
Phone: (248) 723-5880
Fax: (248) 723-5889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | ||
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X |
Profile Details
| NPI number | 1154356517 |
|---|---|
| LBN Legal business name | Mmg 1Pc |
| DBA Doing business as | <Unavail> |
| Authorized official | Trivax, Geoffrey A Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Sep 20th, 2018 - about 8 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 | 1154356517 | NPPES |
| Michigan | Other | 110F300670 | BLUE SHIELD GROUP |
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