Provider Demographics
NPI:1205939618
Name:LOKEH, ADAM (MD)
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:
Last Name:LOKEH
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 46317
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446
Mailing Address - Country:US
Mailing Address - Phone:612-360-7700
Mailing Address - Fax:763-479-3006
Practice Address - Street 1:13911 RIDGEDALE DR. #395
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:612-360-7700
Practice Address - Fax:763-479-3006
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN40568208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN313640000OtherMEDICAL ASSISTANCE
MN1041377OtherPREFERRED ONE
MN1300164OtherMEDICA
MN826S2LOOtherBCBS
MN2175194OtherAMERICAS PPO
MN1041377OtherCBSA
MN313640000Medicaid
MN69847OtherCBSA
MN7284128OtherCIGNA
MN1300164OtherMEDICA
I14491Medicare UPIN
MN313640000Medicaid