Individual
MATTHEW BRENT BILLUPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3707 BRAMBLETON AVE STE 2, ROANOKE, VA 24018-3658
(540) 725-7800
(540) 989-6752
Mailing address
824 BERRYWOOD DR, CALLAWAY, VA 24067-5836
(540) 483-0613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102201962
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780896340
—
VA
Enumeration date
05/04/2007
Last updated
07/21/2021
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