Unknown Individual – Obstetrics & Gynecology Physician, NPI 1720072499

Unknown Individual is a healthcare provider. based in Marietta, Georgia. specializing in Obstetrics & Gynecology Physician. They hold a License No. 11544 (GA). The NPI Number for Unknown Individual is 1720072499

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1720072499
Phone
(770) 422-8700
Address
699 CHURCH ST. NE
Deactivation Date
2 January 2025
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

  • Church Street Northeast, Elizabeth, Marietta, Cobb County, Georgia, 30060, United States

    SUITE 300

    MARIETTA, GA 300601122

    Phone: (770) 422-8700

    Fax: (770) 425-7601

    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 30060)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1720072499?
NPI 1720072499 belongs to Unknown Individual; compare other details if you need extra assurance.
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 Obstetrics & Gynecology Physician in the directory — Clinical services aligned with this taxonomy classification.
Where in Georgia is Unknown Individual registered?
Use Marietta, Georgia as the headline location for Unknown Individual here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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