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Individual

MATTHEW A FITZER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1850A TOWN CENTER PKWY, SUITE 301, RESTON, VA 20190-5851
(703) 709-9701
(703) 709-8084
Mailing address
1850A TOWN CENTER PKWY, SUITE 301, RESTON, VA 20190-5851
(703) 709-9701
(703) 709-8084

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101250534
VA
208600000X
Surgery Physician
2005010623
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207411307
MO
Enumeration date
06/01/2006
Last updated
05/03/2012
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