| Doctor Name: | DR. RICHARD FLOYD TREVIS |
| NPI Number: | 1447594577 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 5101005046 |
| Business Practice Address: | 8782 Stoney Creek Dr South Lyon, MI - 481789492 |
| Business Phone Number: | 2484374945 |
| Business Fax Number: | |
| Mailing Address: | 8782 Stoney Creek Dr, SOUTH LYON |
| State: | MI |
| Postal Code: | 481789492 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2012 |
| NPI Last Update Date: | 11/15/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 5101005046 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |