Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME113141 | FL |
N | 111NI0900X | Internist | ME113141 | FL |
N | 207RH0000X | Hematologist | 0101257665 | VA |
Y | 207RX0202X | Medical Oncology | 0101257665 | VA |
NPI | 1457586208 |
---|---|
Provider Name | Matthew T Whitehurst |
First Address | Spotsylvania, VA 22553-1974 |
Second Address | Fredericksburg, VA 22408-1949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2009 |
Last Update Date | 19/12/2019 |