# VISCITO FAMILY MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861828212
- **Authorized official:** DR. MATTHEW STEPHEN VISCITO M.D. (PROPRIETOR)
- **Authorized official phone:** (701) 757-1999

## Contact information

- **Practice address:** 2750 S 26TH ST, SUITE C, GRAND FORKS, ND 58201-6432
- **Practice address phone:** (701) 757-1999
- **Practice address fax:** (701) 757-0898
- **Mailing address:** 2750 S 26TH ST, SUITE C, GRAND FORKS, ND 58201-6432
- **Mailing address phone:** (701) 757-1999
- **Mailing address fax:** (701) 757-0898

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 10982 | ND | Yes |

## Other

- **Enumeration date:** 09/17/2013
- **Last updated:** 01/07/2014