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

NPI 1174711451

Individual provider · NPI 1174711451 Deactivated

This NPI was deactivated on September 10, 2026. The record is kept for reference and should not be used for billing or referrals.

NPI 1174711451 is listed in the national NPI registry.

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Record details

NPI number1174711451
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—