Unknown Individual – Urology Physician, NPI 1679531669

Unknown Individual is a healthcare provider. based in Grand rapids, Michigan. specializing in Urology Physician. They hold a License No. 5101005885 (MI). The NPI Number for Unknown Individual is 1679531669

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1679531669
Phone
(616) 956-9577
Address
4047 SALADIN DR SE
Deactivation Date
26 August 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

Provider Addresses for Unknown Individual

  • 4047 SALADIN DR SE

    GRAND RAPIDS, MI 495466249

    Phone: (616) 956-9577

    Fax: (616) 956-5988

    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.

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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 49546)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1679531669 as the unique 10-digit identifier.
Is inactive the same as retired for Unknown Individual?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Urology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Grand Rapids, Michigan.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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