Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1811985963

Endocrinology, Diabetes & Metabolism Physician

Unknown Individual is a healthcare provider. based in Portland, Maine. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. 006607 (ME). The NPI Number for Unknown Individual is 1811985963

Main info

Organization

Inactive

62 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1811985963

Phone

(207) 773-6463

Address

477 CONGRESS ST

Deactivation Date

30 October 2025

Doctor Profile

Medical School Name

UNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE

Secondary Phone

2077336463

Graduation Year

1964 (62 years ago)

PAC ID

8224094628

Professional Enrollment ID

I20041207001145

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

Time and Temperature Building, 477, Congress Street, Old Port, Downtown, Portland, Cumberland County, Maine, 04101, United States
5TH FLOOR
PORTLAND, ME 041013427
Phone: (207) 773-6463
Fax: (207) 828-4587
Mailing address matches the actual address.

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.

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.

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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 04101)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?

Use NPI 1811985963 when you need to reference Unknown Individual in forms, claims, or directories.

What is the next step if Unknown Individual is inactive?

Treat inactive as a signal to verify Unknown Individual through official channels.

What field does Unknown Individual work in?

You can think of Unknown Individual as practicing within Endocrinology, Diabetes & Metabolism Physician. Clinical services aligned with this taxonomy classification.

Where is Unknown Individual's primary listing?

We display Portland, Maine because that is what the record indicates for Unknown Individual.

Is this NPI for an individual or an organization?

This listing corresponds to an Individual Provider.