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Organization

SANFORD MEDICAL CENTER FARGO

Active
Other names
Sanford Broadway Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization

Contact information

Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2000

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
204F00000X
Transplant Surgery Physician
207K00000X
Allergy & Immunology Physician
207L00000X
Anesthesiology Physician
207R00000X
Internal Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician
207Y00000X
Otolaryngology Physician
207ZP0101X
Anatomic Pathology Physician
208000000X
Pediatrics Physician
208100000X
Physical Medicine & Rehabilitation Physician
2085R0202X
Diagnostic Radiology Physician
208600000X
Surgery Physician
208800000X
Urology Physician
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
291U00000X
Clinical Medical Laboratory

Other

Enumeration date
08/18/2011
Last updated
11/27/2023
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