Individual
MATTHEW SCOTT SHORTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
90 COLLEGE ST, SUITE A, CHRISTIANSBURG, VA 24073-2982
(540) 382-6613
(540) 382-6614
Mailing address
PO BOX 8310, ROANOKE, VA 24014-0310
(540) 345-3556
(540) 342-2193
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110002605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932395100
—
VA
Enumeration date
09/20/2007
Last updated
07/12/2017
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