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Organization
SANFORD MEDICAL CENTER FARGO
Active
Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Bemidji 1705 Anne St Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
1705 ANNE ST NW, SUITE #5, 6, 7, 8, BEMIDJI, MN 56601-6151
(218) 333-5000
Mailing address
1705 ANNE ST NW, SUITE #5, 6, 7, 8, BEMIDJI, MN 56601-6151
(218) 333-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Enumeration date
08/18/2011
Last updated
11/27/2023
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