Provider Demographics
NPI:1346279627
Name:PICHNEY, GARY A (DPM)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:A
Last Name:PICHNEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:GARY
Other - Middle Name:A
Other - Last Name:PICHNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7600 OSLER DR
Mailing Address - Street 2:SUITE #406
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7703
Mailing Address - Country:US
Mailing Address - Phone:410-583-0770
Mailing Address - Fax:410-583-0771
Practice Address - Street 1:7600 OSLER DR
Practice Address - Street 2:SUITE #406
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7703
Practice Address - Country:US
Practice Address - Phone:410-583-0770
Practice Address - Fax:410-583-0771
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01193213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDT395GAOtherBC/BS OF MD
MDT395GAOtherBC/BS OF MD
MDU54180Medicare UPIN
MD1150850001Medicare NSC