Unknown Individual – Internal Medicine Physician, NPI 1124120738

Unknown Individual is a healthcare provider. based in Madawaska, Maine. specializing in Internal Medicine Physician. They hold a License No. 220703 (MA). The NPI Number for Unknown Individual is 1124120738

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124120738
Phone
(207) 728-6359
Address
460 MAIN ST STE 104
Deactivation Date
31 March 2022
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

  • 460 MAIN ST STE 104

    MADAWASKA, ME 04756

    Phone: (207) 728-6359

    Fax: (207) 728-7614

    Type: Location

  • 8 Commerce Blvd

    Middleboro, MA 023461030

    Phone: (774) 260-9300

    Fax: (774) 260-9305

    Type: Location

  • Northern Maine Medical Center, 194, East Main Street, Fort Kent, Fort Kent Township, Aroostook County, Maine, 04743, United States

    FORT KENT, ME 047431428

    Phone: (207) 728-6359

    Fax: (207) 728-7614

    Type: Mailing

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.

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 04756)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1124120738 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What is Unknown Individual's primary classification?
Internal Medicine Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Madawaska, Maine as a primary anchor for Unknown Individual unless the record lists multiple sites.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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