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General NPI Number Information
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NPI Number | 1639268444
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Entity Type | Individual
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Provider Name | MATTHEW STICH MD
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/13/2023
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Provider Practice Location Address
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Address Line | 6900 ATMORE DR
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City | RICHMOND
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State | VA
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Zip | 23225-5644
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Country | US
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Telephone | 804-674-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 248
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City | BASYE
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State | VA
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Zip | 22810-0248
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Country | US
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Telephone | 703-494-5200
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Fax | 888-534-2234
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 0101041202
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101041202
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License Number State | VA
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