Unknown Individual – Anesthesiology Physician, NPI 1700801800

Unknown Individual is a healthcare provider. based in Midland, Michigan. specializing in Anesthesiology Physician. They hold a License No. 4301040932 (MI). The NPI Number for Unknown Individual is 1700801800

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1700801800
Phone
(989) 839-3606
Address
4005 ORCHARD DR
Deactivation Date
11 September 2024

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9898399494
Graduation Year
1977 (49 years ago)
PAC ID
8820989221
Group Practice PAC ID
3779680715
Professional Enrollment ID
I20110224000846
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

  • Orchard Lab at MidMichigan Medical Center, 4005, Orchard Drive, Midland, Midland County, Michigan, 48640, United States

    MIDLAND, MI 486700001

    Phone: (989) 839-3606

    Fax: (989) 839-1509

    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 48670)

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Provider's Procedures

Unknown Individual performs procedures in Anesthesiology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
ANESTHESIOLOGYMI00142Anesthesia for lens surgery1212
ANESTHESIOLOGYMI00790Anesthesia for procedure in upper abdomen including use of an endoscope1818

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: 3779680715View full group profile
NameSpecialtyState
-MI
-MI
-MI
Certified Registered Nurse Anesthetist (Crna)MI
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1700801800?
NPI 1700801800 belongs to Unknown Individual; compare other details if you need extra assurance.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Anesthesiology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use Midland, Michigan as the reference point for Unknown Individual, then confirm.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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