Unknown Individual – Anatomic Pathology & Clinical Pathology Physician, NPI 1093797433

Anatomic Pathology & Clinical Pathology Physician

Unknown Individual is a healthcare provider. based in Toledo, Ohio. specializing in Anatomic Pathology & Clinical Pathology Physician. They hold a License No. 35071958 (OH). The NPI Number for Unknown Individual is 1093797433

Main info

Organization

Inactive

31 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1093797433

Phone

(800) 234-7944

Address

5620 SOUTHWYCK BLVD

Deactivation Date

21 February 2024

Doctor Profile

Medical School Name

CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY

Secondary Phone

4193833578

Graduation Year

1995 (31 years ago)

PAC ID

2860454477

Group Practice PAC ID

8729983416

Professional Enrollment ID

I20041027000218

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

5620, Southwyck Boulevard, Southwyck, Toledo, Lucas County, Ohio, 43614, United States
TOLEDO, OH 436141501
Phone: (800) 234-7944
Type: Mailing
Mercy Medical Center, 1320, Mercy Drive Northwest, Canton, Stark County, Ohio, 44708, United States
CANTON, OH 447082614
Phone: (330) 489-1000
Type: Location
3000 Arlington Ave
Toledo, OH 436142595
Phone: (419) 383-3470
Fax: (419) 383-2860
Type: Location

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 43614)

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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: 8729983416View full group profile

Name	Specialty	State
DR. CAROL A. BUDZENSKI (PH.D.)	-	OH
DR. ROBERT L JR. BOOTH (M.D.)	P A T H O L O G Y	OH
AAMIR PATEL (MD)	General Surgery, Critical Care (Intensivists)	MI
ALLEN L MARKOWICZ (MD)	-	OH
RACHEL ANN MULLINS (RN)	Nurse Practitioner	OH
SARAH JERGE (PA-C)	-	OH
LANCE D DWORKIN (MD)	-	OH
DR. FOREST RAYMOND SHEPPARD (MD)	General Surgery	ME
DUANGNAPA S. CUDDY (D.O.)	Vascular Surgery, General Surgery	MN
PROF. THERESA M GARRIS (NP-C)	-	OH

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?

For Unknown Individual, use NPI 1093797433 as the unique 10-digit identifier.

Is inactive the same as retired for Unknown Individual?

Inactive registry status can reflect deactivation, consolidation, or data lag.

How would a patient describe Unknown Individual's focus?

For Unknown Individual, the primary taxonomy reads as Anatomic Pathology & Clinical Pathology Physician. Clinical services aligned with this taxonomy classification.

Where in Ohio is Unknown Individual registered?

Use Toledo, Ohio as the headline location for Unknown Individual here.

When was this NPI issued?

Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.