Individual
DR. MATTHEW WAYNE BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 MEDICAL CENTER DR STE G500, HUNTINGTON, WV 25701-3659
(304) 691-1262
Mailing address
1249 15TH ST STE 4093, HUNTINGTON, WV 25701-3662
(304) 691-8722
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
2014-00364
NC
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
3280
WV
Other
Enumeration date
05/04/2009
Last updated
04/23/2025
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