Unknown Individual – Obstetrics & Gynecology Physician, NPI 1629069364

Unknown Individual is a healthcare provider. based in Clinton township, Michigan. specializing in Obstetrics & Gynecology Physician. They hold a License No. 4301050703 (MI). The NPI Number for Unknown Individual is 1629069364

Main info

Organization
Inactive
40 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1629069364
Phone
(586) 286-4430
Address
43201 COMMONS DR
Deactivation Date
28 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1986 (40 years ago)
PAC ID
8921045170
Professional Enrollment ID
I20050411000180
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

  • 43201, Commons Drive, Clinton Township, Macomb County, Michigan, 48038, United States

    CLINTON TOWNSHIP, MI 480381110

    Phone: (586) 286-4430

    Fax: (586) 286-4727

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $20.

Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.

Last reported payment date: 2023-02-28 • Largest payer in this snapshot: ABBVIE INC. ($20).

Total Amount

$20

General + Research + Ownership

Payments

1

Total payment records

General Amount

$20

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-02-28

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$20
View all Open Payments →|Open Payments Risk Radar →

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 48038)

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Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1629069364 when you need to reference Unknown Individual in forms, claims, or directories.
What is the next step if Unknown Individual is inactive?
Treat inactive as a signal to verify Unknown Individual through official channels.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Michigan?
You will see Clinton Township, Michigan on file for Unknown Individual alongside any extra practice locations.
How can I contact Unknown Individual?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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