Unknown Individual – Family Medicine Physician, NPI 1073563987

Unknown Individual is a healthcare provider. based in Newark, Delaware. specializing in Family Medicine Physician. They hold a License No. C2-0000710 (DE). The NPI Number for Unknown Individual is 1073563987

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073563987
Phone
Not provided
Address
200 HYGEIA DRIVE
Deactivation Date
15 April 2021

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
6105181060
Graduation Year
1973 (53 years ago)
PAC ID
3870595382
Group Practice PAC ID
8123200631
Professional Enrollment ID
I20161123000294
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Loading map...

Provider Addresses for Unknown Individual

  • 200 HYGEIA DRIVE

    CCHS PHYSICIAN CONTRACTING, SUITE 2300

    NEWARK, DE 197132049

    Phone:

    Type: Mailing

  • Glasgow Medical Center, 2600, Glasgow Avenue, Melody Meadows II, Newark, New Castle County, Delaware, 19702, United States

    SUITE 100

    NEWARK, DE 19702

    Phone: (302) 836-8350

    Fax: (302) 836-8539

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 19713)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123200631View full group profile
NameSpecialtyState
Physician AssistantPA
Physician AssistantPA
Family PracticePA
-DE
Physician AssistantPA
Nurse PractitionerMD
Family PracticeNY
-VA
Internal MedicinePA
Family PracticeVA

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1073563987 if you need a stable reference for Unknown Individual.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Newark, Delaware for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

Similar Providers

412 SUBURBAN PLZ
NPI: 1760484018

DR. LISA ANN MARTIN (D.O.)

Family Medicine Physician
310 E Pulaski Hwy
NPI: 1427050665

SRIDEVI DONEPUDI (M.D.)

Family Medicine Physician
Christiana Road, Concord Towers, New Castle County, Delaware, 19713:19720, United States
NPI: 1629073606

MS. KATHRYN KELLY BENSON (FNP BC)

Family Nurse Practitioner
PO BOX 25039
NPI: 1720084213

CONSTANTINE W. MICHELL (D.O.)

Family Medicine Physician
1320 PHILADELPHIA PIKE
NPI: 1558368035

GEORGE A. NAMEY (D.O.)

Family Medicine Physician
Glasgow Medical Center, 2600, Glasgow Avenue, Melody Meadows II, Newark, New Castle County, Delaware, 19702, United States
NPI: 1346247699

BRIAN K. JANNEY (D.O.)

Family Medicine Physician
Pearson Professional Centers, 111, Continental Drive, Newark, New Castle County, Delaware, 19713, United States
NPI: 1598763724

KAREN L MCGHEE (DO)

Family Medicine Physician
Pearson Professional Centers, 111, Continental Drive, Newark, New Castle County, Delaware, 19713, United States
NPI: 1174522288

MARK A GLASSNER (MD)

Family Medicine Physician
Newark 24/7 Urgent Care Center, 324, East Main Street, Newark, New Castle County, Delaware, 19711, United States
NPI: 1396746293