Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1679982292

Individual provider · NPI 1679982292 Deactivated

This NPI was deactivated on October 22, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1679982292 is listed in the national NPI registry.

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Record details

NPI number1679982292
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—