Unknown Individual – Pediatrics Physician, NPI 1730110370

Unknown Individual is a healthcare provider. based in Stone mountain, Georgia. specializing in Pediatrics Physician. They hold a License No. 009128 (GA). The NPI Number for Unknown Individual is 1730110370

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1730110370
Phone
(770) 498-9355
Address
1805 PARKE PLAZA CIR
Deactivation Date
13 December 2021
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

Provider Addresses for Unknown Individual

  • 1805 PARKE PLAZA CIR

    STE 103

    STONE MOUNTAIN, GA 30087

    Phone: (770) 498-9355

    Fax: (770) 498-6294

    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 30087)

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Reviews

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Frequently asked questions

Where can patients find Unknown Individual's NPI?
You can confirm Unknown Individual with NPI 1730110370; it appears in the national provider directory.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What field does Unknown Individual work in?
You can think of Unknown Individual as practicing within Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Georgia?
You will see Stone Mountain, Georgia on file for Unknown Individual alongside any extra practice locations.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1730110370. Always confirm identity and privileges with the practice and licensing boards.

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