Provider Demographics
NPI:1902161474
Name:TRINQUE, ADAM J (DPM)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:J
Last Name:TRINQUE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1558 E TRINITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3609
Mailing Address - Country:US
Mailing Address - Phone:334-396-3338
Mailing Address - Fax:
Practice Address - Street 1:1558 E TRINITY BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3609
Practice Address - Country:US
Practice Address - Phone:334-396-3338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3695213E00000X
AL325213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015136900Medicaid
FLIG042XMedicare PIN
FLP01665434Medicare PIN