Unknown Individual – Neuromusculoskeletal Medicine & OMM Physician, NPI 1790783090

Unknown Individual is a healthcare provider. based in Virginia beach, Virginia. specializing in Neuromusculoskeletal Medicine & OMM Physician. They hold a License No. 0101030901 (VA). The NPI Number for Unknown Individual is 1790783090

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1790783090
Phone
(757) 420-2911
Address
5314 PROVIDENCE RD
Deactivation Date
7 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

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Provider Addresses for Unknown Individual

  • 5314, Providence Road, Haven Heights, Virginia Beach, Virginia, 23464, United States

    VIRGINIA BEACH, VA 234644102

    Phone: (757) 420-2911

    Fax: (757) 420-2955

    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.

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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 23464)

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Reviews

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Frequently asked questions

What NPI should I save for Unknown Individual?
Save NPI 1790783090 if you need a stable reference for Unknown Individual.
Is Unknown Individual's inactive status permanent?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What kind of provider is Unknown Individual?
The page reflects Neuromusculoskeletal Medicine & OMM Physician for Unknown Individual. Clinical services aligned with this taxonomy classification.
Does Unknown Individual practice in Virginia?
You will see Virginia Beach, Virginia on file for Unknown Individual alongside any extra practice locations.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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