Provider Demographics
NPI:1164479036
Name:PINKE, RICHARD M (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:PINKE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:405 W GREENLAWN AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2898
Mailing Address - Country:US
Mailing Address - Phone:517-483-7550
Mailing Address - Fax:517-483-7575
Practice Address - Street 1:405 W GREENLAWN AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-2898
Practice Address - Country:US
Practice Address - Phone:517-483-7550
Practice Address - Fax:517-483-7575
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101014796207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4886849Medicaid
MI4886849Medicaid
MI0C36345033Medicare PIN