# VALLEY MEDICAL CLINIC PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Valley Internal Medicine Assoc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164537569
- **Authorized official:** MR. PANJINI M SIVANNA M.D. (PRESIDENT)
- **Authorized official phone:** (701) 297-0817

## Contact information

- **Practice address:** 300 MAIN AVE, STE 200, FARGO, ND 58103-1930
- **Practice address phone:** (701) 297-0817
- **Practice address fax:** (701) 297-6870
- **Mailing address:** 300 MAIN AVE, STE 200, FARGO, ND 58103-1930
- **Mailing address phone:** (701) 297-0817
- **Mailing address fax:** (701) 297-6870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 4806 | ND | Yes |

## Other

- **Enumeration date:** 08/19/2006
- **Last updated:** 04/02/2015