Sanford Children's Southwest Clinic | |
2701 13th Ave S Fargo ND 58103-3602 | |
(701) 234-3600 | |
(701) 234-3528 |
Full Name | Sanford Children's Southwest Clinic |
---|---|
Speciality | Pediatrics |
Location | 2701 13th Ave S, Fargo, North Dakota |
Authorized Official Name and Position | Martha K Leclerc (VP) |
Authorized Official Contact | 7012346248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sanford Children's Southwest Clinic 2701 13th Ave S Fargo ND 58103-3602 Ph: (701) 234-3600 | Sanford Children's Southwest Clinic 2701 13th Ave S Fargo ND 58103-3602 Ph: (701) 234-3600 |
NPI Number | 1033147046 |
---|---|
Provider Enumeration Date | 06/29/2006 |
Last Update Date | 11/27/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033147046 | NPI | - | NPPES |
086712800 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
208000000X | Pediatrics | (* (Not Available)) | Primary |
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