Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1548266679

Individual provider · NPI 1548266679 Deactivated

This NPI was deactivated on September 24, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1548266679 is listed in the national NPI registry.

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Record details

NPI number1548266679
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—