Individual
JOHN QA MATTERN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1051 LOFTIS BLVD, SUITE 100, NEWPORT NEWS, VA 23606-3069
(757) 873-9400
(757) 873-9420
Mailing address
6350 CENTER DR STE 200, NORFOLK, VA 23502-4107
(757) 213-5700
(757) 213-5701
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
0102024256
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005808855
—
VA
01
—
110054750
RAILROAD MEDICARE
VA
01
—
55097
OPTIMA
VA
Enumeration date
06/17/2005
Last updated
01/17/2019
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