Provider Demographics
NPI:1053360172
Name:DINCHER, GARY MICHAEL (DPM)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:MICHAEL
Last Name:DINCHER
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 1:445 RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-3722
Mailing Address - Country:US
Mailing Address - Phone:570-326-7600
Mailing Address - Fax:570-326-2550
Practice Address - Street 1:445 RIVER AVE
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3722
Practice Address - Country:US
Practice Address - Phone:570-326-7600
Practice Address - Fax:570-326-2550
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002714L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2000006OtherHIGHMARK BLUE SHIELD
PA0070163430002Medicaid
PA822424OtherFIRST PRIORITY HEALTH
PAP00449760OtherRAILROAD MEDICARE
PA6041400001Medicare NSC
PA120145Medicare PIN