Unknown Individual – Infectious Disease Physician, NPI 1932108479

Unknown Individual is a healthcare provider. based in Keego harbor, Michigan. specializing in Infectious Disease Physician. They hold a License No. AM030664 (MI). The NPI Number for Unknown Individual is 1932108479

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1932108479
Phone
(248) 681-0360
Address
2112 CASS LAKE RD
Deactivation Date
30 October 2024

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1971 (55 years ago)
PAC ID
0345319760
Professional Enrollment ID
I20080527000188
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

  • 2112, Cass Lake Road, Keego Harbor, Oakland County, Michigan, 48320, United States

    KEEGO HARBOR, MI 483201272

    Phone: (248) 681-0360

    Fax: (248) 681-6749

    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
99213Established patient office or other outpatient visit, 20-29 minutes20485$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes8616$0
99442Telephone medical discussion with physician, 11-20 minutes6141$0
99214Established patient office or other outpatient visit, 30-39 minutes2925$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes2417$0
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Insurance plans in this area (ZIP 48320)

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Reviews

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Frequently asked questions

What is the registry number for Unknown Individual?
The registry entry for Unknown Individual shows NPI 1932108479.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What type of care does Unknown Individual provide?
Unknown Individual's profile centers on Infectious Disease Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Keego Harbor, Michigan. Check all listed addresses for suites or satellite offices.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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