Healthcare Provider Details

I. General information

NPI: 1073705521
Provider Name (Legal Business Name): VERONICA J MATTHEWS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 TIMBEROAK CT
LYNCHBURG VA
24502-3459
US

IV. Provider business mailing address

66 TIMBEROAK CT
LYNCHBURG VA
24502-3459
US

V. Phone/Fax

Practice location:
  • Phone: 434-237-6236
  • Fax: 434-237-9951
Mailing address:
  • Phone: 434-989-5414
  • Fax: 434-979-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101240587
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: