Unknown Individual – Cardiovascular Disease Physician, NPI 1083769210

Unknown Individual is a healthcare provider. based in Pontiac, Michigan. specializing in Cardiovascular Disease Physician. They hold a License No. 4301037520 (MI). The NPI Number for Unknown Individual is 1083769210

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1083769210
Phone
(248) 858-6772
Address
44405 WOODWARD AVE
Deactivation Date
7 September 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

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Provider Addresses for Unknown Individual

  • Saint Joseph Mercy Oakland, 44405, Woodward Avenue, Pontiac, Oakland County, Michigan, 48341, United States

    PONTIAC, MI 483415023

    Phone: (248) 858-6772

    Fax: (248) 858-6974

    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 48341)

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Reviews

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Frequently asked questions

What unique ID ties claims to Unknown Individual?
NPI 1083769210 is assigned to Unknown Individual under the national enumeration system.
How do I interpret inactive records for Unknown Individual?
Treat inactive as a signal to verify Unknown Individual through official channels.
Can you summarize Unknown Individual's specialty in plain language?
Clinically, the directory lists Unknown Individual with Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Michigan?
You will see Pontiac, Michigan on file for Unknown Individual alongside any extra practice locations.
What if Pontiac, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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