Unknown Individual – General Practice Physician, NPI 1982630273

Unknown Individual is a healthcare provider. based in Royal oak, Michigan. specializing in General Practice Physician. They hold a License No. 4301059159 (MI). The NPI Number for Unknown Individual is 1982630273

Main info

Organization
Inactive
58 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1982630273
Phone
(248) 585-9368
Address
632 POPLAR AVE
Deactivation Date
4 January 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1968 (58 years ago)
PAC ID
6406855949
Professional Enrollment ID
I20061212000166
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

  • 632, Poplar Avenue, Royal Oak, Oakland County, Michigan, 48073, United States

    ROYAL OAK, MI 48073

    Phone: (248) 585-9368

    Fax: (248) 585-2334

    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 48073)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1982630273 for Unknown Individual.
What should I verify if Unknown Individual is listed inactive?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights General Practice Physician. Clinical services aligned with this taxonomy classification.
What city is tied to Unknown Individual?
The directory associates Unknown Individual with Royal Oak, Michigan. Check all listed addresses for suites or satellite offices.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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