Unknown Individual – Neurological Surgery Physician, NPI 1760569842

Unknown Individual is a healthcare provider. based in St louis, Missouri. specializing in Neurological Surgery Physician. They hold a License No. 26655 (MO). The NPI Number for Unknown Individual is 1760569842

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1760569842
Phone
(314) 977-4440
Address
3691 RUTGER AVE
Deactivation Date
10 July 2024
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

  • 3691 RUTGER AVE

    PROVIDER ENROLLMENT

    ST LOUIS, MO 63110

    Phone: (314) 977-4440

    Type: Mailing

  • 3635 VISTA AVE 3RD FLOOR

    DEPARTMENT OF SURGERY

    ST LOUIS, MO 63110

    Phone: (314) 577-8796

    Fax: (314) 268-5061

    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 63110)

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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 1760569842 on file in the registry.
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 Neurological Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Missouri is Unknown Individual registered?
Use St Louis, Missouri as the headline location for Unknown Individual here.
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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