Unknown Individual – Phlebology Physician, NPI 1649217159

Unknown Individual is a healthcare provider. based in Maple grove, Minnesota. specializing in Phlebology Physician. They hold a License No. 9896 (ND). The NPI Number for Unknown Individual is 1649217159

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1649217159
Phone
(763) 447-2500
Address
7365 KIRKWOOD CT N
Deactivation Date
22 November 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • Maple Grove, Langmuir, Drumpark, Bargeddie, North Lanarkshire, Scotland, G69, United Kingdom

    STE 120

    MAPLE GROVE, MN 553694721

    Phone: (763) 447-2500

    Fax: (763) 447-2505

    Type: Location

  • 4133, 30th Avenue South, Anderson Park, Fargo, Cass County, North Dakota, 58104, United States

    STE 101

    FARGO, ND 581048421

    Phone: (701) 232-8346

    Fax: (701) 232-9297

    Type: Mailing

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

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 55369)

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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 1649217159 on file in the registry.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
How would a patient describe Unknown Individual's focus?
For Unknown Individual, the primary taxonomy reads as Phlebology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Maple Grove, Minnesota.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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