Provider Demographics
NPI:1508951641
Name:DINNEEN, ANNETTE M (MD)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:M
Last Name:DINNEEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8433 HARCOURT ROAD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260
Mailing Address - Country:US
Mailing Address - Phone:317-338-9393
Mailing Address - Fax:317-338-9399
Practice Address - Street 1:8433 HARCOURT ROAD
Practice Address - Street 2:SUITE 310
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260
Practice Address - Country:US
Practice Address - Phone:317-338-9393
Practice Address - Fax:317-338-9399
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2014-02-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01042219207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000084544OtherUNICARE
IL000000084544OtherBLUE CROSS BLUE SHIELD OF
258635OtherHEALTHLINK
351494388OtherTRICARE NORTH REGION
000000084544OtherUNITED FOOD & COMM WORKER
000000084544OtherELECTRICAL WORKERS
000000084544OtherBLUE CROSS OF CALIFORNIA
024440OtherSIHO SOUTHEASTERN IN HEAL
193523OtherONE HEALTH PLAN
000000084544OtherITT HARTFORD UNICARE
000000084544OtherIN COMPREHENSIVE HEALTH I
000000084544OtherICHIA
P00283868OtherRAILROAD MEDICARE
000000084544OtherEMPIRE BLUE CROSS BLUE SH
430810OtherAETNA
000000084544OtherANTHEM
351494388OtherCIGNA
000000084544OtherIN COMPREHENSIVE HEALTH I
IN345220Medicare PIN