Provider Demographics
NPI:1639168552
Name:DINCHMAN, KURT H (MD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:H
Last Name:DINCHMAN
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:PO BOX 636643
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6643
Mailing Address - Country:US
Mailing Address - Phone:440-989-3801
Mailing Address - Fax:440-960-0264
Practice Address - Street 1:3600 KOLBE RD
Practice Address - Street 2:STE 209
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-1654
Practice Address - Country:US
Practice Address - Phone:440-282-5522
Practice Address - Fax:440-282-5368
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35064656D208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3025372Medicaid
OH0932870Medicaid
OHF60718Medicare UPIN
OH0932870Medicaid
OH3025372Medicaid
OH9389631Medicare PIN