Provider Demographics
NPI:1992083992
Name:DINCHER, MATTHEW R (PA)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:R
Last Name:DINCHER
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 1:122 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2608
Mailing Address - Country:US
Mailing Address - Phone:304-250-0382
Mailing Address - Fax:304-250-0383
Practice Address - Street 1:122 GEORGE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2608
Practice Address - Country:US
Practice Address - Phone:304-250-0382
Practice Address - Fax:304-250-0383
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01779363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical