Organization
NORTHLAND FAMILY PHYSICIANS LLC
Active
Other names
Aurora Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK G PETERSON MD (PRESIDENT)
(701) 732-2700
Entity
Organization
Contact information
Practice address
2650 32ND AVE S STE D, GRAND FORKS, ND 58201-6541
(701) 732-2700
(701) 732-2701
Mailing address
PO BOX 5210, GRAND FORKS, ND 58206-5210
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057629800
—
MN
05
—
13638
—
ND
01
—
269P4NO
BCBS OF MN
MN
01
—
6692001
BCBS OF ND
ND
Enumeration date
04/07/2006
Last updated
07/21/2022
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