Organization
SANFORD CLINIC NORTH
Active
Other names
Sanford Moorhead Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K LECLERC (VP)
(701) 234-6248
Entity
Organization
Contact information
Practice address
1301 8TH ST S, MOORHEAD, MN 56560-3604
(701) 234-3200
(701) 234-3286
Mailing address
1301 8TH ST S, MOORHEAD, MN 56560-3604
(701) 234-3200
(701) 234-3286
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
907519400
—
MN
Enumeration date
07/09/2006
Last updated
11/02/2011
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