Healthcare Provider Details

I. General information

NPI: 1184911356
Provider Name (Legal Business Name): MATTHEW DAVID HUK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2011
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 JOHNSTON WILLIS DR STE 200
NORTH CHESTERFIELD VA
23235-4871
US

IV. Provider business mailing address

PO BOX 402924
ATLANTA GA
30384-2924
US

V. Phone/Fax

Practice location:
  • Phone: 804-320-2705
  • Fax: 804-330-2433
Mailing address:
  • Phone: 804-320-2705
  • Fax: 804-330-2433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101272518
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: