Organization
SANFORD CLINIC NORTH
Active
Organization
SANFORD CLINIC NORTH
Active
Other names
Sanford Neuroscience Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K LECLERC (VP)
(701) 234-6248
Entity
Organization
Contact information
Practice address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
(701) 234-4134
Mailing address
700 1ST AVE S, FARGO, ND 58103-1802
(701) 234-4036
(701) 234-4134
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
103T00000X
Psychologist
—
—
207T00000X
Neurological Surgery Physician
—
—
2084N0400X
Neurology Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
648513800
—
MN
Enumeration date
07/25/2006
Last updated
11/27/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up