Provider Demographics
NPI:1740263995
Name:BARCINAS, GARY P (PA)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:P
Last Name:BARCINAS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 STANLEY ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-9115
Mailing Address - Country:US
Mailing Address - Phone:864-505-6144
Mailing Address - Fax:
Practice Address - Street 1:111 STANLEY ST
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-9115
Practice Address - Country:US
Practice Address - Phone:864-505-6144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCA956363A00000X
WV582363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00208330OtherRAILROAD MEDICARE
SCS957397169Medicare PIN
7169Medicare PIN