Unknown Individual – Internal Medicine Physician, NPI 1083000376

Unknown Individual is a healthcare provider. based in Cheverly, Maryland. specializing in Internal Medicine Physician. They hold a License No. H84984 (MD). The NPI Number for Unknown Individual is 1083000376

Main info

Organization
Inactive
11 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1083000376
Phone
(391) 618-6699
Address
3001 HOSPITAL DR
Deactivation Date
30 January 2022

Doctor Profile

Medical School Name
OHIO UNIVERSITY, COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
3016186699
Graduation Year
2015 (11 years ago)
PAC ID
8628325081
Group Practice PAC ID
8729138003
Professional Enrollment ID
I20180717003243
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

  • 3001 HOSPITAL DR

    CHEVERLY, MD 207851189

    Phone: (391) 618-6699

    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.

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 20785)

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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: 8729138003View full group profile
NameSpecialtyState
-VA
Internal MedicineMD
Internal MedicineVA
Internal MedicineMA
Physician AssistantMA
Physician AssistantMD
-VA
Pediatric MedicineMD
-MD
Internal Medicine, HospitalistOH

Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1083000376 on file in the registry.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Cheverly, Maryland.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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