Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1821603572

Individual provider · NPI 1821603572 Deactivated

This NPI was deactivated on October 29, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1821603572 is listed in the national NPI registry.

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Record details

NPI number1821603572
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—