Unknown Individual – Obstetrics & Gynecology Physician, NPI 1033476692

Unknown Individual is a healthcare provider. based in Savannah, Georgia. specializing in Obstetrics & Gynecology Physician. They hold a License No. 80630 (GA). The NPI Number for Unknown Individual is 1033476692

Main info

Organization
Inactive
12 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1033476692
Phone
(912) 819-7878
Address
602 E 72ND ST
Deactivation Date
17 May 2023

Doctor Profile

Medical School Name
MERCER UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9126921080
Graduation Year
2014 (12 years ago)
PAC ID
6800106410
Group Practice PAC ID
4385909936
Professional Enrollment ID
I20180913000343
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 602 E 72ND ST

    SAVANNAH, GA 314054913

    Phone: (912) 819-7878

    Type: Mailing

  • 5354 REYNOLDS ST STE 518

    SAVANNAH, GA 31405

    Phone: (912) 819-9650

    Fax: (912) 819-9651

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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

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

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Medicare Utilization (FFS)

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

Insurance plans in this area (ZIP 31405)

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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: 4385909936View full group profile
NameSpecialtyState
Nurse PractitionerGA
O B S T E T R I C S/ G Y N E C O L O G YSC
-GA
-GA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YSC
Nurse PractitionerGA
O B S T E T R I C S/ G Y N E C O L O G YGA
O B S T E T R I C S/ G Y N E C O L O G YGA

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1033476692 when you need to reference Unknown Individual in forms, claims, or directories.
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.
What kind of provider is Unknown Individual?
The page reflects Obstetrics & Gynecology Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Savannah, Georgia 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.

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