Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC002714L | PA |
NPI | 1053360172 |
---|---|
Provider Name | Gary Michael Dincher |
First Address | Williamsport, PA 17701-3722 |
Second Address | Williamsport, PA 17701-3722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 22/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0070163430002 | (05) | PA |
2000006 | HIGHMARK BLUE SHIELD (01) | PA |
822424 | FIRST PRIORITY HEALTH (01) | PA |
P00449760 | RAILROAD MEDICARE (01) | PA |
T-29470 | (02) | PA |