MEDICARE: GARY MICHAEL DINCHER D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	SC002714L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00449760	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2000006	OTHER	PA	HIGHMARK BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	822424	OTHER	PA	FIRST PRIORITY HEALTH

General Provider Information

NPI Number	:	1053360172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY MICHAEL DINCHER D.P.M.

Provider Business Mailing Address
First Line	:	445 RIVER AVE
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-3722
Country	:	US
Telephone Number	:	570-326-7600
Fax Number	:	570-326-2550

Provider Business Practice Location Address
First Line	:	445 RIVER AVE
Second Line	:
City	:	WILLIAMSPORT
State	:	PA
Zip	:	17701-3722
Country	:	US
Telephone Number	:	570-326-7600
Fax Number	:	570-326-2550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	01/22/2021

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