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

NPI 1083025274

Individual provider · NPI 1083025274 Deactivated

This NPI was deactivated on October 1, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1083025274 is listed in the national NPI registry.

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Record details

NPI number1083025274
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—