Unknown Individual – Colon & Rectal Surgery Physician, NPI 1629050828

Unknown Individual is a healthcare provider. based in Royal oak, Michigan. specializing in Colon & Rectal Surgery Physician. They hold a License No. 4301032798 (MI). The NPI Number for Unknown Individual is 1629050828

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1629050828
Phone
(248) 541-8554
Address
1121 CROOKS RD
Deactivation Date
27 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

  • 1121, Crooks Road, Royal Oak, Oakland County, Michigan, 48067, United States

    ROYAL OAK, MI 48067

    Phone: (248) 541-8554

    Fax: (248) 541-1791

    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 48067)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1629050828 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Colon & Rectal Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does Unknown Individual serve?
Unknown Individual's listing highlights Royal Oak, Michigan; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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