Healthcare Provider Details

I. General information

NPI: 1124132758
Provider Name (Legal Business Name): MATTHEW HULL PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 MONUMENT RD SUITE 1100
YORK PA
17403-5024
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-851-2441
  • Fax: 717-260-3322
Mailing address:
  • Phone: 717-851-2441
  • Fax: 717-260-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA051758
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: