Individual
MATTHEW R NOORBAKHSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-4756
(434) 924-9999
Mailing address
PO BOX 749112, ATLANTA, GA 30374-9112
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
0101282491
VA
2086S0102X
Surgical Critical Care Physician
Primary
0101282491
VA
2086S0102X
Surgical Critical Care Physician
MD452246
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102958520
—
PA
01
—
12720669
CAQH
—
Enumeration date
06/20/2008
Last updated
09/23/2024
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