Unknown Individual – Geriatric Medicine (Family Medicine) Physician, NPI 1639175128
Geriatric Medicine (Family Medicine) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
753 HIGHWAY 466
LADY LAKE, FL 321596340
Phone: (352) 268-0003
Type: Location
9555 Seminole Blvd
Ste 104
Seminole, FL 337722522
Phone: (727) 394-1500
Fax: (727) 394-1505
Type: Location
449 Quarter St
Gladwin, MI 486241918
Phone: (989) 426-3430
Type: Location
MidMichigan Medical Center, 4000, Wellness Drive, Midland, Midland County, Michigan, 48640, United States
MIDLAND, MI 486702000
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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 32159)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.