NPI 1477238533 · live from the CMS NPI Registry
Matthew Dewitt Davis, PA
Physician Assistant in Fargo, ND. National Provider Identifier 1477238533, active.
NPI record
| NPI | 1477238533 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 801 Broadway N, Fargo, ND 58102 |
| Practice phone | 701-234-2000 |
| Mailing address | Po Box 5074, Sioux Falls, SD 57117 |
| Enumerated | June 16, 2023 |
| Last updated | July 20, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PAC1010 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.