Unknown Individual – Internal Medicine Physician, NPI 1639284540

Unknown Individual is a healthcare provider. based in Farmington hills, Michigan. specializing in Internal Medicine Physician. They hold a License No. 5101007381 (MI). The NPI Number for Unknown Individual is 1639284540

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1639284540
Phone
(947) 521-8000
Address
28050 Grand River Ave
Deactivation Date
27 March 2024

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
5862632300
Graduation Year
1977 (49 years ago)
PAC ID
2860522935
Group Practice PAC ID
6709891286
Professional Enrollment ID
I20100616000566

Contacts

Secure Messaging
sjohnsonreed96837@direct.beaumont.edu
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 28050 Grand River Ave

    Farmington Hills, MI 483365919

    Phone: (947) 521-8000

    Type: Location

  • Freemans Family Dentistry DDS PC - Ronald J. Macafee, 20905, Greenfield Road, Southfield, Oakland County, Michigan, 48075, United States

    SUITE 704

    SOUTHFIELD, MI 480755360

    Phone: (248) 559-7494

    Fax: (248) 559-3575

    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.

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 48336)

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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: 6709891286View full group profile
NameSpecialtyState
Internal MedicineMI
-MI
-MI
-MI
Internal MedicineMI
Emergency Medicine, Pulmonary Disease, Internal MedicineMI
-MI
-MI
-MI
Internal MedicineMI

Reviews

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Frequently asked questions

What is the 10-digit NPI for Unknown Individual?
Unknown Individual — NPI 1639284540 — is the standard way to identify this listing.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Internal Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Farmington Hills, Michigan may find Unknown Individual in results; validate coverage separately.
Why does Unknown Individual have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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