Individual
KIMBERLY ANN MATZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2710 PROSPERITY AVE, SUITE 200, FAIRFAX, VA 22031-4357
(703) 280-2841
(703) 280-4773
Mailing address
2710 PROSPERITY AVE, SUITE 200, FAIRFAX, VA 22031-4357
(703) 280-2841
(703) 280-4773
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
224443
MA
208C00000X
Colon & Rectal Surgery Physician
Primary
0101248220
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861579898
—
VA
Enumeration date
11/01/2006
Last updated
09/04/2012
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