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General NPI Number Information
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NPI Number | 1104036086
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Entity Type | Organization
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Legal Business Name | R. MICHAEL MATCHETT, M.D., P.C.
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 11/11/2009
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Provider Practice Location Address
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Address Line | 1018 CATON DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3140
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Country | US
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Telephone | 757-481-1278
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Fax |
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Provider Business Mailing Address
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Address Line | 1018 CATON DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3140
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Country | US
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Telephone | 757-481-1278
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT MICHAEL MATCHETT
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Credential | M.D.
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Telephone | 757-481-1278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101032294
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License Number State | VA
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