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Organization
SANFORD MEDICAL CENTER FARGO
Active
Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Health 929 Central Ave Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
929 CENTRAL AVE NW, EAST GRAND FORKS, MN 56721-1917
(218) 773-6800
Mailing address
929 CENTRAL AVE NW, EAST GRAND FORKS, MN 56721-1917
(218) 773-6800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/18/2011
Last updated
11/27/2023
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