Healthcare Provider Details

I. General information

NPI: 1295599678
Provider Name (Legal Business Name): MATTHEW HARTUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DEWITT LOOP
FORT BELVOIR VA
22060-5285
US

IV. Provider business mailing address

8703 BRADGATE RD
ALEXANDRIA VA
22308-2312
US

V. Phone/Fax

Practice location:
  • Phone: 571-231-1803
  • Fax:
Mailing address:
  • Phone: 704-904-9964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101288047
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: