Individual
MATTHEW PETER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
575 INDUSTRIAL DR, LOUISA, VA 23093-4146
(540) 967-2011
(540) 967-2982
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
—
—
207Q00000X
Family Medicine Physician
Primary
0101235756
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144203308
—
VA
Enumeration date
11/22/2005
Last updated
07/31/2021
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