Provider Demographics
NPI:1902801947
Name:BUCHINSKY, VINCENT J (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:BUCHINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8691 STONEWALL RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4510
Mailing Address - Country:US
Mailing Address - Phone:703-368-1182
Mailing Address - Fax:703-257-6711
Practice Address - Street 1:8691 STONEWALL RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4510
Practice Address - Country:US
Practice Address - Phone:703-368-1182
Practice Address - Fax:703-257-6711
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034986207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005621372Medicaid
B08003Medicare UPIN
080005500Medicare ID - Type Unspecified