Unknown Individual – Pulmonary Disease Physician, NPI 1528011004

Unknown Individual is a healthcare provider. based in Grand blanc, Michigan. specializing in Pulmonary Disease Physician. They hold a License No. 5101007135 (MI). The NPI Number for Unknown Individual is 1528011004

Main info

Organization
Inactive
50 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1528011004
Phone
(810) 695-4000
Address
9450 S SAGINAW RD
Deactivation Date
3 June 2021

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
9894885470
Graduation Year
1976 (50 years ago)
PAC ID
0345237079
Group Practice PAC ID
4981501939
Professional Enrollment ID
I20040426001854
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

  • 9450, South Saginaw Road, Grand Blanc, Genesee County, Michigan, 48439, United States

    SUITE E

    GRAND BLANC, MI 484398206

    Phone: (810) 695-4000

    Fax: (810) 695-4055

    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 48439)

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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: 4981501939View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineMI
-MI
Internal MedicineMI
Internal MedicineMI
-MI
Hospitalist, Internal MedicineMI
-MI
Nurse PractitionerMI
Physician AssistantMI
Internal MedicineMI

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1528011004 — the number used across U.S. healthcare to identify this provider.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Pulmonary Disease Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Grand Blanc?
Unknown Individual currently maps to Grand Blanc, Michigan in this extract.
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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