MEDICARE: DR. MATTHEW TIMOTHY HUEMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	01056708A	IN
2	2086X0206X	Surgical Oncology Physician	MD047745	DC
3	208600000X	Surgery Physician	0101232968	VA
4	2086X0206X	Surgical Oncology Physician	D0066188	MD
5	2086X0206X	Surgical Oncology Physician	0101232968	VA

General Provider Information

NPI Number	:	1780621656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW TIMOTHY HUEMAN M.D.

Provider Business Mailing Address
First Line	:	3040 WILLIAMS DR STE 100
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4618
Country	:	US
Telephone Number	:	571-350-8400
Fax Number	:	703-940-8692

Provider Business Practice Location Address
First Line	:	44035 RIVERSIDE PKWY STE 310
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20176-8273
Country	:	US
Telephone Number	:	571-350-8400
Fax Number	:	703-724-7503

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	04/24/2024

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