Unknown Individual – Cardiovascular Disease Physician, NPI 1760472328

Unknown Individual is a healthcare provider. based in Southfield, Michigan. specializing in Cardiovascular Disease Physician. They hold a License No. 4301034684 (MI). The NPI Number for Unknown Individual is 1760472328

Main info

Organization
Inactive
63 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1760472328
Phone
(248) 557-5650
Address
18500 W 12 MILE RD
Deactivation Date
3 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2485575650
Graduation Year
1963 (63 years ago)
PAC ID
8325229321
Professional Enrollment ID
I20110224000140
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

  • 12 Mile Road, Berkley, Oakland County, Michigan, 48072, United States

    SUITE 1

    SOUTHFIELD, MI 480762674

    Phone: (248) 557-5650

    Fax: (248) 557-5656

    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
99214Established patient office or other outpatient visit, 30-39 minutes4915$0
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report4516$0
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Insurance plans in this area (ZIP 48076)

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Reviews

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Frequently asked questions

How is Unknown Individual identified in CMS data?
CMS-hosted NPPES data lists Unknown Individual with NPI 1760472328.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's primary classification?
Cardiovascular Disease Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Southfield, Michigan; more addresses can appear in NPPES.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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