Unknown Individual – Diagnostic Radiology Physician, NPI 1710952601

Unknown Individual is a healthcare provider. based in West bloomfield, Michigan. specializing in Diagnostic Radiology Physician. They hold a License No. 5101006542 (MI). The NPI Number for Unknown Individual is 1710952601

Main info

Organization
Inactive
53 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710952601
Phone
(248) 408-9023
Address
3775 ORCHARD LAKE RD APT 103
Deactivation Date
25 December 2025

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
2485690296
Graduation Year
1973 (53 years ago)
PAC ID
5991787673
Group Practice PAC ID
7719884741
Professional Enrollment ID
I20040605000166
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Orchard Lake Road, West Bloomfield Township, Oakland County, Michigan, 48334, United States

    WEST BLOOMFIELD, MI 483241600

    Phone: (248) 408-9023

    Fax: (248) 681-9187

    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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93880Ultrasound of both sides of head and neck blood flow3333$0
76700Complete ultrasound scan of abdomen2525$0
93971Ultrasound study of one arm or leg veins with compression and maneuvers2323$0
76770Complete ultrasound scan behind abdominal cavity2321$0
93922Ultrasound study of arm and leg arteries1716$0
View full utilization report →

Insurance plans in this area (ZIP 48324)

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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: 7719884741View full group profile
NameSpecialtyState
Diagnostic RadiologyMI
Diagnostic RadiologyMI
Cardiovascular Disease (Cardiology), Internal MedicineMI
Diagnostic RadiologyFL
Certified Registered Nurse Anesthetist (Crna)MI
Diagnostic RadiologyFL
Diagnostic Radiology, Family PracticeLA
Anesthesiology, Interventional Pain Management, Interventional Pain Management, AnesthesiologyIL
Cardiovascular Disease (Cardiology), Internal MedicineMI
Internal Medicine, Nuclear Medicine, Cardiovascular Disease (Cardiology)MI

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1710952601.
Does inactive mean outdated data for Unknown Individual?
Inactive status means the NPI record is not marked active in the public file — verify before making care decisions.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Diagnostic Radiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with West Bloomfield, Michigan. Check all listed addresses for suites or satellite offices.
Why is information missing for Unknown Individual?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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