Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Health Edgewood Vista Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
4420 37TH AVE S, FARGO, ND 58104-3400
(701) 365-4746
Mailing address
4420 37TH AVE S, FARGO, ND 58104-3400
(701) 365-4746
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
08/18/2011
Last updated
11/27/2023
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