Individual
DR. MATTHEW ROBERT CHURCHILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3020 HAMAKER CT, SUITE 400, FAIRFAX, VA 22031-2238
(703) 876-0800
(703) 876-0866
Mailing address
3020 HAMAKER CT, SUITE 400, FAIRFAX, VA 22031-2238
(703) 876-0800
(703) 876-0866
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
0101244345
VA
2084P0301X
Brain Injury Medicine (Psychiatry & Neurology) Physician
0101244345
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235335993
—
VA
Enumeration date
06/21/2007
Last updated
06/08/2022
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