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General NPI Number Information
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NPI Number | 1366478760
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Entity Type | Organization
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Legal Business Name | SANFORD HEALTH NETWORK NORTH
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 600 1ST ST SE
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City | MAYVILLE
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State | ND
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Zip | 58257-1518
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Country | US
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Telephone | 701-788-4500
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Fax | 701-788-4545
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Provider Business Mailing Address
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Address Line | 600 1ST ST SE
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City | MAYVILLE
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State | ND
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Zip | 58257-1518
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Country | US
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Telephone | 701-788-4500
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Fax | 701-788-4545
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Authorized Official
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Title or Position | SUPERVISOR
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Name | SHANNON TEEMAN
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Credential |
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Telephone | 701-234-1094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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