Unknown Individual – Diagnostic Radiology Physician, NPI 1124028576

Unknown Individual is a healthcare provider. based in Saint cloud, Minnesota. specializing in Diagnostic Radiology Physician. They hold a License No. 30840 (MN). The NPI Number for Unknown Individual is 1124028576

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1124028576
Phone
(320) 257-5595
Address
PO BOX 7366
Deactivation Date
22 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

  • PO BOX 7366

    SAINT CLOUD, MN 563027366

    Phone: (320) 257-5595

    Fax: (320) 257-5596

    Type: Mailing

  • Connecticut Avenue South, Sartell, Stearns County, Minnesota, 5377, United States

    SARTELL, MN 563772554

    Phone: (320) 257-5595

    Fax: (320) 257-5596

    Type: Location

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.

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Medicare Enrollment & Revalidation

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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 56302)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1124028576?
NPI 1124028576 belongs to Unknown Individual; compare other details if you need extra assurance.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What expertise is attributed to Unknown Individual?
Unknown Individual's specialty line reads Diagnostic Radiology Physician. Clinical services aligned with this taxonomy classification.
Where in Minnesota is Unknown Individual registered?
Use Saint Cloud, Minnesota as the headline location for Unknown Individual here.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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