Unknown Individual – Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician, NPI 1902908684

Unknown Individual is a healthcare provider. based in Ypsilanti, Michigan. specializing in Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. They hold a License No. 4301032553 (MI). The NPI Number for Unknown Individual is 1902908684

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1902908684
Phone
(734) 712-5500
Address
5325 ELLIOTT DR
Deactivation Date
20 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

Provider Addresses for Unknown Individual

  • 5325 ELLIOTT DR

    SUITE 102

    YPSILANTI, MI 481978633

    Phone: (734) 712-5500

    Fax: (734) 712-8209

    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 48197)

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Reviews

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Frequently asked questions

Is Unknown Individual listed with a National Provider Identifier?
Yes — Unknown Individual has NPI 1902908684 on file in the registry.
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 Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Ypsilanti?
Unknown Individual currently maps to Ypsilanti, Michigan in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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