Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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NPI 1518617679

Individual provider · NPI 1518617679 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 1518617679 is listed in the national NPI registry.

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Record details

NPI number1518617679
Entity typeIndividual (Type 1)
NPI enumerated—
Last updated in NPPES—