Unknown Individual – Internal Medicine Physician, NPI 1306817523

Unknown Individual is a healthcare provider. based in Allen park, Michigan. specializing in Internal Medicine Physician. They hold a License No. 4301046694 (MI). The NPI Number for Unknown Individual is 1306817523

Main info

Organization
Inactive
44 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1306817523
Phone
(313) 388-0033
Address
7804 ALLEN RD
Deactivation Date
22 July 2022

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
3133880033
Graduation Year
1982 (44 years ago)
PAC ID
4284615071
Group Practice PAC ID
3971675125
Professional Enrollment ID
I20040527000384
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

  • 7804, Allen Road, Allen Park, Wayne County, Michigan, 48101, United States

    ALLEN PARK, MI 481011702

    Phone: (313) 388-0033

    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 48101)

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Provider's Procedures

Unknown Individual performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEMI81002Urinalysis, manual test3430
INTERNAL MEDICINEMI85610Blood test, clotting time17321

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: 3971675125View full group profile
NameSpecialtyState
MARTHA ELLEN GENIG
-MI

Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1306817523.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Allen Park, Michigan may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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Unknown Individual

Internal Medicine Physician
15101, Southfield Road, Downtown Allen Park, Allen Park, Wayne County, Michigan, 48101, United States
NPI: 1821161621