Healthcare Provider Details

I. General information

NPI: 1144791104
Provider Name (Legal Business Name): MATTHEW DOUGLAS PAINTER FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MEDICAL CENTER DR
FISHERSVILLE VA
22939-2332
US

IV. Provider business mailing address

419 JOCELYN LN
WAYNESBORO VA
22980-9651
US

V. Phone/Fax

Practice location:
  • Phone: 540-245-7080
  • Fax: 540-245-7081
Mailing address:
  • Phone: 540-448-2112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024176892
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: