Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Health Detroit Lakes Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Mailing address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
08/18/2011
Last updated
11/27/2023
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