Unknown Individual – Emergency Medicine Physician, NPI 1356362297

Emergency Medicine Physician

Unknown Individual is a healthcare provider. based in East liverpool, Ohio. specializing in Emergency Medicine Physician. They hold a License No. 35063449L (OH). The NPI Number for Unknown Individual is 1356362297

Main info

Organization

Inactive

43 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1356362297

Phone

(330) 429-3300

Address

1275 FAULK AVE

Deactivation Date

13 March 2024

Doctor Profile

Medical School Name

OTHER

Secondary Phone

3303857200

Graduation Year

1983 (43 years ago)

PAC ID

9436324233

Group Practice PAC ID

9830437508

Professional Enrollment ID

I20111206000528

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience19

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

1275 FAULK AVE
EAST LIVERPOOL, OH 439204030
Phone: (330) 429-3300
Type: Mailing
East Liverpool City Hospital, 425, West 5th Street, Diamond Historic District, Jethro, East Liverpool, Columbiana County, Ohio, 43920, United States
EAST LIVERPOOL, OH 439202405
Phone: (330) 386-2010
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 43920)

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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: 9830437508View full group profile

Name	Specialty	State
DR. AMIR YUSEF ABDULHAY (DO)	Emergency Medicine	PA
RAVINDER CHOPRA (MD)	Emergency Medicine	OH
BRIGHAM CLAUDER DUNN	Emergency Medicine, Family Practice	NM
JOHN COLUMBUS (MD)	Emergency Medicine	OH
RICHARD HOUCK (DO)	Emergency Medicine	WV
DR. CHRISTOPHER RANDOLPH O'NEAL (D.O.)	Emergency Medicine	WV
DR. CHRISTOPHER MICHAEL GOOCH (DO)	Emergency Medicine	OH
JOSEPH J. MATULA (DO)	-	NJ
DR. JOSEPH A. KIDD (D.O.)	Emergency Medicine	TN
MS. CHRISTINE RADIVOJ (FNP-BC)	Nurse Practitioner	OH