Provider Demographics
NPI:1689781809
Name:BARVINCHACK, MICHAEL E (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:E
Last Name:BARVINCHACK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19426 LEITERSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-1438
Mailing Address - Country:US
Mailing Address - Phone:301-714-4929
Mailing Address - Fax:301-714-1383
Practice Address - Street 1:19426 LEITERSBURG PIKE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-1438
Practice Address - Country:US
Practice Address - Phone:301-714-4929
Practice Address - Fax:301-714-1383
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01964111NS0005X, 111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD442RMedicare ID - Type Unspecified
MDU82852Medicare UPIN