Healthcare Provider Details

I. General information

NPI: 1043457674
Provider Name (Legal Business Name): MICHAEL DINKELS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2009
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1971 WESTERN AVE # 197
ALBANY NY
12203-5066
US

IV. Provider business mailing address

1971 WESTERN AVE # 197
ALBANY NY
12203-5066
US

V. Phone/Fax

Practice location:
  • Phone: 518-360-1526
  • Fax: 518-407-5679
Mailing address:
  • Phone: 518-360-1526
  • Fax: 518-407-5679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number247721
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number247721
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: