Unknown Individual – Plastic Surgery Physician, NPI 1770567489

Unknown Individual is a healthcare provider. based in West bloomfield, Michigan. specializing in Plastic Surgery Physician. They hold a License No. 4301048717 (MI). The NPI Number for Unknown Individual is 1770567489

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1770567489
Phone
(248) 538-3020
Address
5641 W MAPLE RD
Deactivation Date
12 April 2022
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

  • West Maple Road, Birmingham, Bloomfield Township, Oakland County, Michigan, 48009:48304, United States

    WEST BLOOMFIELD, MI 48322

    Phone: (248) 538-3020

    Fax: (248) 538-0892

    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 48322)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1770567489 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Plastic Surgery Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near West Bloomfield, Michigan may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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