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NPI Code Detail

MEDICARE: SANFORD CLINIC NORTH

MEDICARE: SANFORD CLINIC NORTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician
2207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447295134
Entity Type Code : Organization
Provider Name (Legal Business Name) : SANFORD CLINIC NORTH
Provider Business Mailing Address
First Line : 1220 SHEYENNE ST
Second Line :
City : WEST FARGO
State : ND
Zip : 58078-2637
Country : US
Telephone Number : 701-234-4445
Fax Number : 701-234-4393
Provider Business Practice Location Address
First Line : 1220 SHEYENNE ST
Second Line :
City : WEST FARGO
State : ND
Zip : 58078-2637
Country : US
Telephone Number : 701-234-4445
Fax Number : 701-234-4393
Authorized Official
Title or Position : VP
Name : MARTHA K LECLERC
Credential :
Telephone Number : 701-234-6248
Provider Enumeration Date : 06/18/2006
Last Update Date : 11/27/2023

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Directions to “SANFORD CLINIC NORTH ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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