Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301105284 | MI |
N | 208600000X | Surgeon | 4301105284 | MI |
Y | 2086S0105X | Surgery of the Hand | 68099 | MN |
NPI | 1083028161 |
---|---|
Provider Name | Dr. Matthew Peter Fahrenkopf |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-2543 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2014 |
Last Update Date | 11/11/2021 |