Organization
SANFORD CLINIC NORTH
Active
Other names
Sanford Bemidji 1705 Anne St. Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K LECLERC (VP)
(701) 234-6248
Entity
Organization
Contact information
Practice address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-5000
(218) 333-4766
Mailing address
1705 ANNE ST NW, BEMIDJI, MN 56601-6151
(218) 333-5000
(218) 333-4766
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410013100
—
MN
Enumeration date
07/08/2006
Last updated
11/27/2023
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