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Individual

DAVID A. TRENKNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11141 PARKVIEW PLAZA DR STE 110, FORT WAYNE, IN 46845-1714
(260) 266-9100
(260) 266-9101
Mailing address
7910 W JEFFERSON BLVD STE 110, FORT WAYNE, IN 46804-4159
(260) 436-4116
(260) 436-1878

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01031940A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000614692
ANTHEM PIN
IN
05
0788081
OH
05
100321320
IN
05
103434971
MI
05
104239274
MI
01
300039787
MEDICARE RAILROAD
IN
Enumeration date
08/02/2005
Last updated
03/11/2013
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