Provider Demographics
NPI:1598747727
Name:DINKEL, TROY ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:ADAM
Last Name:DINKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5373 GARDENIA CT
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-9070
Mailing Address - Country:US
Mailing Address - Phone:630-247-0455
Mailing Address - Fax:
Practice Address - Street 1:9556 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-1313
Practice Address - Country:US
Practice Address - Phone:314-656-7899
Practice Address - Fax:314-373-5757
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051806A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000365246OtherANTHEM
IN000000090527OtherANTHEM
IN200262920Medicaid
IN226540CMedicare PIN
IN000000090527OtherANTHEM
IN000000365246OtherANTHEM
IN930087361Medicare PIN
IN809640VMedicare PIN