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NPI Code Detail

MEDICARE: MATTHEW PETER O'NEILL BARTOLOZZI DO

MEDICARE: MATTHEW PETER O'NEILL BARTOLOZZI DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramVA

General Provider Information

NPI Number : 1174470421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW PETER O'NEILL BARTOLOZZI DO
Provider Business Mailing Address
First Line : 9012 WEST ST
Second Line :
City : MANASSAS
State : VA
Zip : 20110-5024
Country : US
Telephone Number : 703-853-3972
Fax Number :
Provider Business Practice Location Address
First Line : 9300 DEWITT LOOP
Second Line :
City : FORT BELVOIR
State : VA
Zip : 22060-5285
Country : US
Telephone Number : 571-231-3224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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