Unknown Individual – Podiatrist, NPI 1396746319

Unknown Individual is a healthcare provider. based in Farmington hills, Michigan. specializing in Podiatrist. They hold a License No. 5901000456 (MI). The NPI Number for Unknown Individual is 1396746319

Main info

Organization
Inactive
70 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396746319
Phone
(248) 626-5830
Address
30335 W 13 MILE RD
Deactivation Date
30 August 2025

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
-
Graduation Year
1956 (70 years ago)
PAC ID
1254395726
Professional Enrollment ID
I20041117000144
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

  • 30335, West 13 Mile Road, Farmington Hills, Oakland County, Michigan, 48334, United States

    SUITE 106

    FARMINGTON HILLS, MI 483342262

    Phone: (248) 626-5830

    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 48334)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1396746319 in the public NPI dataset.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Podiatrist is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Farmington Hills, Michigan as a primary anchor for Unknown Individual unless the record lists multiple sites.
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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