MMG 1PC (NPI# 1205855186) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205855186 |
| Entity Type | Organization |
| Organization Name | MMG 1PC |
| Practice Address |
7419 Middlebelt Rd Suite 4 West Bloomfield MI 48322-4182 |
| Mailing Address |
29992 Northwestern Hwy Ste C Farmington Hills MI 48334-3292 |
| Practice Telephone | 2488552291 |
| Practice Fax Number | 2488554901 |
| Mailing Telephone | 2488511430 |
| Mailing Fax Number | 2488515182 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-09-20 |
| Authorized Official Name | DR. GEOFFREY A TRIVAX (PRESIDENT) |
| Authorized Official Telephone | 3135383099 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BLUE SHIELD GROUP | 700F321510 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215040506 | Mmg 1pc | Internal Medicine | 28625 Northwestern Hwy Ste 100, Southfield, MI 48034-8351 | 2006-08-17 |
| 1285873430 | Mmg 1pc | Physical Medicine & Rehabilitation | 28625 Northwestern Hwy, Suite 150, Southfield, MI 48034-1828 | 2009-02-11 |
| 1184878001 | Mmg 1pc | Psychiatry & Neurology | 26400 W 12 Mile Rd, Suite 170, Southfield, MI 48034-1700 | 2008-11-05 |
| 1215103940 | Mmg 1pc | General Practice | 28625 Northwestern Hwy, Suite 213, Southfield, MI 48034-1828 | 2008-05-02 |
| 1972700607 | Mmg 1pc | Physical Therapist | 26400 W 12 Mile Rd, Suite 25, Southfield, MI 48034-1700 | 2007-06-27 |
| 1881714723 | Mmg 1pc | Internal Medicine | 28000 Joy Rd, Livonia, MI 48150-4137 | 2007-03-31 |
| 1629184049 | Mmg 1pc | Internal Medicine | 28625 Northwestern Hwy, Suite 223, Southfield, MI 48034-1828 | 2006-08-21 |
| 1679586192 | Mmg 1pc | Internal Medicine | 29201 Telegraph Rd, Suite 404, Southfield, MI 48034-1331 | 2006-08-14 |
| 1023037025 | Mmg 1pc | Nurse Practitioner | 28625 Northwestern Hwy, Suite 213, Southfield, MI 48034-1828 | 2006-07-19 |
| 1073548442 | Mmg 1pc | Internal Medicine | 6900 Orchard Lake Rd, Suite 303, West Bloomfield, MI 48322-3405 | 2006-07-12 |
| Street Address |
7419 MIDDLEBELT RD SUITE 4 |
| City | WEST BLOOMFIELD |
| State | MI |
| Zip Code | 48322-4182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407838535 | Asghar Afsari | Obstetrics & Gynecology | 7419 Middlebelt Rd, Suite 1, West Bloomfield, MI 48322-4182 | 2005-11-15 |
| 1508192824 | Asghar Afsari, M.d., P.C. | Obstetrics & Gynecology | 7419 Middlebelt Rd, Suite 1, West Bloomfield, MI 48322-4182 | 2009-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483492 | Life Saver Home Health, LLC | Home Health | 6436 Silverbrooke, West Bloomfield, MI 48322 | 2020-10-06 |
| 1316557374 | Gabrielle Benaderet | Speech-Language Pathologist | 6548 Heritage, West Bloomfield, MI 48322 | 2020-08-05 |
| 1437774197 | Madeline Gail Tenenbaum | Social Worker | 6800 W. Maple Rd., West Bloomfield, MI 48322 | 2020-06-09 |
| 1639705676 | Stephanie Cole | Social Worker | 5749 Crossgate, West Bloomfield, MI 48322 | 2020-03-22 |
| 1407409709 | Laura Elizabeth Large | Social Worker | Couseling Associates, Inc., 6960 Orchard Lake Rd. Ste. 100, W. Bloomfield, MI 48322 | 2019-07-17 |
| 1144796533 | Jaleesa Davis | Home Health Aide | 6436 Silverbrook W, West Bloomfield, MI 48322 | 2018-10-23 |
| 1912484411 | Mjl Therapy Pllc | Clinic/Center | 5745 West Maple Road Suite 213, West Bloomfield, MI 48322 | 2018-07-26 |
| 1396247847 | Martha Gomez-pedraza | Physical Therapist | 6200 Orchard Lake Rd - Suite Ll9, West Bloomfield, MI 48322 | 2018-03-01 |
| 1659872174 | Jennifer Marie O'connor | Physical Therapist | Beaumont Medical Center West Bloomfield, 6900 Orchard Lake Rd., Suite Ll09, West Bloomfield, MI 48322 | 2018-02-21 |
| 1851890834 | Naomi Marie Lang | Physical Therapy Assistant | 6535 Drake Rd. West, Bloomfield Township, MI 48322 | 2018-02-06 |
| Find all providers in zip 48322 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093160798 | Joann Riggins-wodhouse | Family Medicine | 3495 Pine Estates Dr, West Bloomfield, MI 48323-1956 | 2016-05-01 |
| 1497027783 | Paul Forman | Family Medicine | 6715 Alden Dr, West Bloomfield, MI 48324-2011 | 2012-02-01 |
| 1861710493 | Healthy Affair, Pllc | Family Medicine | 2600 Lone Pine Rd, West Bloomfield, MI 48323-3642 | 2010-05-06 |
| 1427217363 | Paul Schneider | Family Medicine | 7636 Danbury Cir, West Bloomfield, MI 48322-3569 | 2008-06-05 |
| 1851578397 | Beth Lynn-eisenberg Rubin | Family Medicine | 4408 Westover Dr, West Bloomfield, MI 48323-2874 | 2008-01-28 |
| 1366641573 | Chong U Yi | Family Medicine | 2030 Lochaven Rd, West Bloomfield, MI 48324-3919 | 2007-07-17 |
| 1134326507 | Zivit Cohen | Family Medicine | 7125 Orchard Lake Rd Ste 100, West Bloomfield, MI 48322 | 2007-06-29 |
| 1952508467 | Stephen Simon Friedman | Family Medicine | 2960 Middlebelt Rd, West Bloomfield, MI 48323-1931 | 2007-06-28 |
| 1114136207 | Harry Maisel | Family Medicine | 6052 Cochise Dr, West Bloomfield, MI 48322-2359 | 2007-05-22 |
| 1730208166 | Joshua S. Smith | Family Medicine | 6733 West Maple Rd, Suite 114, West Bloomfield, MI 48322 | 2007-03-28 |
| Find all providers in WEST BLOOMFIELD | ||||
| City | WEST BLOOMFIELD |
| Zip Code | 48322 |
Please comment or provide details below to improve the information on MMG 1PC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.