Unknown Individual – Specialist, NPI 1720078298

Unknown Individual is a healthcare provider. based in Poland, Ohio. specializing in Specialist. They hold a License No. 35-04-8666 (OH). The NPI Number for Unknown Individual is 1720078298

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1720078298
Phone
(330) 884-3993
Address
PO BOX 5174
Deactivation Date
19 June 2024

Doctor Profile

Medical School Name
OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
-
Graduation Year
1977 (49 years ago)
PAC ID
0941108013
Professional Enrollment ID
I20031229000124
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

  • Poland Post Office, West McKinley Way, South Main Street Historic District, Poland, Mahoning County, Ohio, 44514, United States

    POLAND, OH 445140174

    Phone: (330) 884-3993

    Fax: (888) 439-5935

    Type: Mailing

  • McKay Court, Shops at Boardman Park, McKay's Corners, Boardman Township, Mahoning County, Ohio, 44512, United States

    BOARDMAN, OH 445125771

    Phone: (330) 884-3993

    Fax: (888) 439-5935

    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 44514)

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Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1720078298 when you need to reference Unknown Individual in forms, claims, or directories.
Why would Unknown Individual's listing show inactive?
Inactive in NPPES means the identifier is not currently active in that dataset.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Other Service Providers. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Poland, Ohio for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1720078298. Always confirm identity and privileges with the practice and licensing boards.

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