Unknown Individual – Dermatology Physician, NPI 1407050818

Unknown Individual is a healthcare provider. based in Williamsburg, Virginia. specializing in Dermatology Physician. They hold a License No. 0102202189 (VA). The NPI Number for Unknown Individual is 1407050818

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1407050818
Phone
(757) 564-8535
Address
207 Bulifants Blvd Ste C
Deactivation Date
21 February 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

  • 207 Bulifants Blvd Ste C

    Williamsburg, VA 231885732

    Phone: (757) 564-8535

    Type: Location

  • 1248 Perimeter Pkwy Ste 482

    Virginia Beach, VA 234545914

    Phone: (757) 496-5085

    Type: Location

  • 733 Volvo Pkwy Ste 120

    Chesapeake, VA 233201609

    Phone: (757) 389-5544

    Type: Location

  • 1540 Breezeport Way Ste 100

    Suffolk, VA 234353752

    Phone: (757) 745-7261

    Type: Location

  • 11842 Rock Landing Dr Ste 120

    Newport News, VA 236064437

    Phone: (757) 595-8816

    Type: Location

  • Secep Administrative Offices, 6160, Kempsville Circle, Glen Rock, Janaf, Norfolk, Virginia, 23502, United States

    SUITE 200A

    NORFOLK, VA 235023933

    Phone: (757) 622-6315

    Fax: (757) 625-6940

    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.

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 23188)

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Provider's Procedures

Unknown Individual performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYVA17003Destruction of 2-14 skin growths3869696

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1407050818 in the public NPI dataset.
Is Unknown Individual excluded from programs when inactive?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What healthcare role does Unknown Individual hold?
Scheduling teams often label Unknown Individual under Dermatology Physician. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Williamsburg, Virginia 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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