Unknown Individual – Internal Medicine Physician, NPI 1730356965

Unknown Individual is a healthcare provider. based in Charlevoix, Michigan. specializing in Internal Medicine Physician. They hold a License No. 026637 (MI). The NPI Number for Unknown Individual is 1730356965

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1730356965
Phone
(231) 547-6889
Address
12411 MEANDERLINE RD
Deactivation Date
31 January 2022
Data current as of
20 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

  • 12411, Meanderline Road, Charlevoix Township, Charlevoix County, Michigan, 49720, United States

    CHARLEVOIX, MI 497201072

    Phone: (231) 547-6889

    Fax: (231) 237-4323

    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 49720)

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Reviews

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Frequently asked questions

What federal number belongs to Unknown Individual?
The federal identifier for Unknown Individual is NPI 1730356965.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Internal Medicine Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Michigan?
You will see Charlevoix, Michigan on file for Unknown Individual alongside any extra practice locations.
What if Charlevoix, Michigan seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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