Provider Demographics
NPI:1497932446
Name:GARY A PICHNEY DPM
Entity Type:Organization
Organization Name:GARY A PICHNEY DPM
Other - Org Name:MID-ATLANTIC FOOT & ANKLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PICHNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-583-0770
Mailing Address - Street 1:7600 OSLER DRIVE
Mailing Address - Street 2:STE 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:
Practice Address - Street 1:7600 OSLER DRIVE
Practice Address - Street 2:STE 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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01193332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1150850001Medicare NSC