MEDICARE: BARRY L. KATCHINOFF M.D.

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	174400000X	Specialist	0101035727	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130008251	OTHER	VA	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821056623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY L. KATCHINOFF M.D.

Provider Business Mailing Address
First Line	:	7305 BOULDER VIEW LN
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4953
Country	:	US
Telephone Number	:	804-282-6828
Fax Number	:	804-320-0966

Provider Business Practice Location Address
First Line	:	7305 BOULDER VIEW LN
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23225-4953
Country	:	US
Telephone Number	:	804-282-6828
Fax Number	:	804-320-0966

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	08/31/2015

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