Unknown Individual – Podiatrist, NPI 1619984465

Unknown Individual is a healthcare provider. based in Westland, Michigan. specializing in Podiatrist. They hold a License No. DH000950 (MI). The NPI Number for Unknown Individual is 1619984465

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1619984465
Phone
(734) 728-4300
Address
37382 GLENWOOD DR
Deactivation Date
5 March 2026

Doctor Profile

Medical School Name
KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
Secondary Phone
-
Graduation Year
1979 (47 years ago)
PAC ID
7012080195
Professional Enrollment ID
I20080723000123
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

  • Glenwood Road, Westland, Wayne County, Michigan, 48186, United States

    WESTLAND, MI 48186

    Phone: (734) 728-4300

    Fax: (734) 728-4315

    Type: Location

  • Northville Post Office, 151, North Main Street, Village of Northville, Town of Northampton, Fulton County, New York, 12134, United States

    NORTHVILLE, MI 481675500

    Phone: (734) 728-4300

    Fax: (734) 728-4315

    Type: Mailing

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 48186)

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Provider's Procedures

Unknown Individual performs procedures in Podiatrist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PODIATRYMI11056Removal of 2 to 4 thickened skin growths322189

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1619984465 when you need to reference Unknown Individual in forms, claims, or directories.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Podiatrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Westland, Michigan for Unknown Individual; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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