Provider Demographics
NPI:1285796292
Name:RINKER, ANDREA R (DPM)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:R
Last Name:RINKER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 NORTH MACOMB STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2968
Mailing Address - Country:US
Mailing Address - Phone:734-241-1222
Mailing Address - Fax:734-241-6825
Practice Address - Street 1:721 NORTH MACOMB STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2968
Practice Address - Country:US
Practice Address - Phone:734-241-1222
Practice Address - Fax:734-241-6825
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI5901000949213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI146517OtherSELECTCARE
MI5941680OtherAETNA
MI88132AOtherHAP
MI2619256Medicaid
MI03289OtherPARAMOUNT
MI712522OtherFAMILY HEALTH
MI382896881002OtherCIGNA
MI5941680OtherAETNA
MI146517OtherSELECTCARE
T34121Medicare UPIN