Unknown Individual – Neurology Physician, NPI 1962453704

Unknown Individual is a healthcare provider. based in Fort wayne, Indiana. specializing in Neurology Physician. They hold a License No. 45777 (WI). The NPI Number for Unknown Individual is 1962453704

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1962453704
Phone
Not provided
Address
11109 PARKVIEW PLAZA DR # 117
Deactivation Date
24 April 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 11109 PARKVIEW PLAZA DR # 117

    FORT WAYNE, IN 468451701

    Phone:

    Type: Mailing

  • 11109 PARKVIEW PLAZA DR

    FORT WAYNE, IN 468451701

    Phone: (260) 425-6780

    Fax: (260) 425-6615

    Type: Location

  • Marshfield Clinic Marshfield Center, 1000, North Oak Avenue, Marshfield, Wood County, Wisconsin, 54449, United States

    MARSHFIELD, WI 544495703

    Phone: (715) 387-5511

    Type: Mailing

  • 2116, Craig Road, Eau Claire, Eau Claire County, Wisconsin, 54701, United States

    EAU CLAIRE, WI 547016149

    Phone: (715) 858-4500

    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

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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 46845)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1962453704.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Neurology Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Fort Wayne, Indiana for Unknown Individual; expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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