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Contact Information

MATTHEW L JUSTUS, PA-C
202 TOWN SQUARE ST.
GLADE SPRING, VA24340
 Phone: 276-429-1410
 Fax: 276-783-2879
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Emergency Medical Services

207PE0004X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for MATTHEW L JUSTUS · (Male)

NPI Number 1821033895
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 06/16/2006
Last updated 05/20/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0110001912
  • WV License # 01170
  • TN Medicaid Q007384
  • VA Medicaid 1821033895
  • VA Other P01198022 RR MEDICARE
Hospital affiliation(s)
  • SMYTH COUNTY COMMUNITY HOSPITAL - (Acute Care)
    245 MEDICAL PARK DRIVE
    MARION, VA 24354
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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