Unknown Individual – Pediatric Cardiology Physician, NPI 1609967504

Unknown Individual is a healthcare provider. based in East lansing, Michigan. specializing in Pediatric Cardiology Physician. They hold a License No. 4301031039 (MI). The NPI Number for Unknown Individual is 1609967504

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1609967504
Phone
(517) 355-3308
Address
B240 LIFE SCIENCES BLDG
Deactivation Date
20 March 2024
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

  • B240 LIFE SCIENCES BLDG

    DEPARTMENT OF PEDIATRICS & HUMAN DEVELOPMENT

    EAST LANSING, MI 48824

    Phone: (517) 355-3308

    Type: Mailing

  • Michigan State University Federal Credit Union, 1200, East Michigan Avenue, Lansing, Lansing Charter Township, Ingham County, Michigan, 48912, United States

    SUITE 145

    LANSING, MI 489121800

    Phone: (517) 364-5440

    Fax: (517) 364-5466

    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 ·

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48824)

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Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1609967504.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
Which specialty label fits Unknown Individual?
NPPES ties Unknown Individual to Pediatric Cardiology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to East Lansing, Michigan?
If you are local to East Lansing, Michigan, Unknown Individual may be relevant to your search.
Who maintains Unknown Individual's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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