NPI 1619288305 · live from the CMS NPI Registry
Brent Michael Buchholz, PA-C
Physician Assistant in Fargo, ND. National Provider Identifier 1619288305, active.
NPI record
| NPI | 1619288305 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 2101 Elm St, Primary Care, Fargo, ND 58102 |
| Practice phone | 701-239-3700 |
| Enumerated | June 28, 2010 |
| Last updated | March 4, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PAC0428 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.