# ALTIUS FAMILY AND SPORTS MEDICINE, PLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093772766
- **Authorized official:** DR. MATTHEW WALTER MARCHAL M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (804) 290-0593

## Contact information

- **Practice address:** 2530 GASKINS RD, SUITE A, RICHMOND, VA 23238-1483
- **Practice address phone:** (804) 290-0593
- **Practice address fax:** (804) 290-0594
- **Mailing address:** 2530 GASKINS RD, SUITE A, RICHMOND, VA 23238-1483
- **Mailing address phone:** (804) 290-0593
- **Mailing address fax:** (804) 290-0594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/27/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 437410 | AETNA | — |