1285796292 NPI number — MS. ANDREA R RINKER DPM

Table of content: MS. ANDREA R RINKER DPM (NPI 1285796292)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285796292 NPI number — MS. ANDREA R RINKER DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RINKER
Provider First Name:
ANDREA
Provider Middle Name:
R
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1285796292
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
721 NORTH MACOMB STREET
Provider Second Line Business Mailing Address:
SUITE 5
Provider Business Mailing Address City Name:
MONROE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48162-2968
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-241-1222
Provider Business Mailing Address Fax Number:
734-241-6825

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
721 NORTH MACOMB STREET
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
MONROE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48162-2968
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-241-1222
Provider Business Practice Location Address Fax Number:
734-241-6825
Provider Enumeration Date:
12/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  MI5901000949 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 146517 . This is a "SELECTCARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5941680 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 88132A . This is a "HAP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 2619256 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 03289 . This is a "PARAMOUNT" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 712522 . This is a "FAMILY HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 382896881002 . This is a "CIGNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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