Organization Name: | MILLENNIUM MEDICAL GROUP PC |
NPI Number: | 1073548442 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GEOFFREY A TRIVAX (PRESIDENT) |
Mailing Address: | 6900 Orchard Lake Rd Suite 303 West Bloomfield |
State: | MI US |
Postal Code: | 483223405 |
Phone Number: | 2488514192 |
Fax Number: | 2487379774 |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 08/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207RC0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Internal Medicine |
Taxonomy Specialization: | Cardiovascular Disease |
Taxonomy Definition: | An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |