Individual
PHILLIP MATTHEW HARTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7001 W BROAD ST, STE A, RICHMOND, VA 23294-3701
(804) 673-2722
(804) 282-5723
Mailing address
671 HIOAKS RD, SUITE B, RICHMOND, VA 23225-4072
(804) 272-5814
(804) 560-0232
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48848
TN
207R00000X
Internal Medicine Physician
MD436849
PA
207RN0300X
Nephrology Physician
Primary
0101254122
VA
390200000X
Student in an Organized Health Care Education/Training Program
MT189010
PA
Other
Enumeration date
10/29/2008
Last updated
12/07/2016
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