Unknown Individual – Internal Medicine Physician, NPI 1174630396

Internal Medicine Physician

Unknown Individual is a healthcare provider. based in Martins ferry, Ohio. specializing in Internal Medicine Physician. They hold a License No. 35100243 (OH). The NPI Number for Unknown Individual is 1174630396

Main info

Organization

Inactive

61 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1174630396

Phone

(740) 232-6104

Address

222 N. FIFTH STREET

Deactivation Date

24 May 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

7406951210

Graduation Year

1965 (61 years ago)

PAC ID

6002913472

Group Practice PAC ID

5799689493

Professional Enrollment ID

I20070518000286

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

Provider Addresses for Unknown Individual

222 N. FIFTH STREET
SUITE 102
MARTINS FERRY, OH 43935
Phone: (740) 232-6104
Fax: (740) 609-3483
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 43935)

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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: 5799689493View full group profile

Name	Specialty	State
MS. CHELSEA W HEWITT (PA)	Physician Assistant	WV
LAURA MAY MILLER (DO)	-	WV
CHELSEA MCLAUGHLIN (AGACNP)	Nurse Practitioner	PA
JAMIE LEE SESZKO (FNP-BC)	Nurse Practitioner	OH
HAYGEN EKATERINA MOWDER	Nurse Practitioner	WV
CHELSEA M CAMERLENGO (PA-C)	Physician Assistant	WV
OLIVIA LEE GRAY	Physician Assistant	PA
RICHARD A IRVIN	Family Practice	WV
MS. CHRISTINA TERRI DIMECH (M.D.)	E N D O C R I N O L O G Y	ONTARIO
AARON L. SCAIFE (M.D.)	O B S T E T R I C S/ G Y N E C O L O G Y	WV

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?

Use NPI 1174630396 when you need to reference Unknown Individual in forms, claims, or directories.

How do I interpret inactive records for Unknown Individual?

Treat inactive as a signal to verify Unknown Individual through official channels.

What does Unknown Individual treat or focus on?

Patients typically see Unknown Individual under the specialty Internal Medicine Physician. Clinical services aligned with this taxonomy classification.

What location shows for Unknown Individual?

We surface Martins Ferry, Ohio for Unknown Individual based on available NPPES addresses.

What if Martins Ferry, Ohio seems incomplete?

Street-level detail can be omitted — open the full address list for this NPI.