Unknown Individual – Endocrinology, Diabetes & Metabolism Physician, NPI 1588708044

Unknown Individual is a healthcare provider. based in Duluth, Minnesota. specializing in Endocrinology, Diabetes & Metabolism Physician. They hold a License No. 51315 (MN). The NPI Number for Unknown Individual is 1588708044

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1588708044
Phone
(218) 249-7890
Address
1011 E 1ST ST
Deactivation Date
14 September 2022

Doctor Profile

Medical School Name
WESTERN UNIVERSITY OF HEALTH SCIENCES COLLEGE OF DENTAL MED
Secondary Phone
2182497860
Graduation Year
2002 (24 years ago)
PAC ID
4284788605
Group Practice PAC ID
7113834839
Professional Enrollment ID
I20090820000142

Contacts

Secure Messaging
him@slk.direct.slhduluth.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness85
Years active:0State licenses:1Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 1011 E 1ST ST

    DULUTH, MN 558052242

    Phone: (218) 249-7890

    Fax: (218) 249-7899

    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 55805)

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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: 7113834839View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
-MN
Vascular SurgeryIL
Physician AssistantMN
Emergency MedicineMN
-MN
Emergency MedicineMN
-MN
Physician AssistantMN
Hematology/Oncology, Internal MedicineMN

Reviews

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Frequently asked questions

What identifier follows Unknown Individual across health systems?
The NPI 1588708044 uniquely identifies Unknown Individual in U.S. healthcare data.
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 does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Endocrinology, Diabetes & Metabolism Physician. Clinical services aligned with this taxonomy classification.
Can patients visit Unknown Individual in Duluth, Minnesota?
For routing, start with Duluth, Minnesota for Unknown Individual, then verify phone and hours locally.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.

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