Unknown Individual – Pediatrics Physician, NPI 1891771408

Unknown Individual is a healthcare provider. based in Brookhaven, Georgia. specializing in Pediatrics Physician. They hold a License No. 30356 (GA). The NPI Number for Unknown Individual is 1891771408

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1891771408
Phone
(404) 321-4692
Address
3369 BUFORD HWY NE STE 810
Deactivation Date
29 April 2026
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

  • 3369 BUFORD HWY NE STE 810

    BROOKHAVEN, GA 303293722

    Phone: (404) 321-4692

    Fax: (404) 321-4366

    Type: Mailing

  • 4166 Buford Hwy NE Ste 11021103

    Atlanta, GA 303451081

    Phone: (404) 366-3636

    Fax: (404) 362-0808

    Type: Location

  • 4905 COURTNEY DR

    FOREST PARK, GA 302971427

    Phone: (404) 366-3636

    Fax: (404) 362-0808

    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.

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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 30329)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1891771408?
NPI 1891771408 belongs to Unknown Individual; compare other details if you need extra assurance.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Pediatrics Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Brookhaven?
Unknown Individual currently maps to Brookhaven, Georgia in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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