Unknown Individual – Internal Medicine Physician, NPI 1790707511

Unknown Individual is a healthcare provider. based in Smyrna, Delaware. specializing in Internal Medicine Physician. They hold a License No. C1-0012543 (DE). The NPI Number for Unknown Individual is 1790707511

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790707511
Phone
(484) 432-4021
Address
104 BRAXTON TER
Deactivation Date
18 October 2022

Contacts

Main Contact
XML
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness85
Years active:0State licenses:2Other namesUpdated within 12 months

Provider Addresses for Unknown Individual

  • 104 BRAXTON TER

    SMYRNA, DE 199774051

    Phone: (484) 432-4021

    Fax: (302) 223-6179

    Type: Mailing

  • EMPIRE MEDICAL

    CAMDEN, DE 19134

    Phone: (302) 387-4343

    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.

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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 19977)

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Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1790707511 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Internal Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Delaware is Unknown Individual registered?
Use Smyrna, Delaware as the headline location for Unknown Individual here.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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