NPI 1679157630 · live from the CMS NPI Registry
Matthew Christopher Johnson, MD
Dermatology in Fargo, ND. National Provider Identifier 1679157630, active.
NPI record
| NPI | 1679157630 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Dermatology 207N00000X |
| Practice location | 4656 40th Ave S Ste 130, Fargo, ND 58104 |
| Practice phone | 701-234-8860 |
| Mailing address | Po Box 5074, Sioux Falls, SD 57117 |
| Enumerated | May 6, 2021 |
| Last updated | September 24, 2025 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | 22670 (ND) |
| Dermatology primary | 207N00000X | 2023-01305 (NC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.