Sanford Clinic North
Organization Active NPI Family Medicine Physician · Hawley, MN
NPI 1710909304 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1710909304
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- SANFORD CLINIC NORTH
- Practice address
- 1412 Main Street
Hawley, MN 56549-0746 - Phone
- (218) 483-3564
- Fax
- (218) 483-3567
- NPI assigned
- Jul 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Martha K Leclerc
- Title
- VP
- Phone
- (701) 234-6248
National Provider Directory
Locations
720 4th St N
Fargo, ND 58122
Phone (701) 234-3310
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X |
Addresses
Primary practice location
1412 Main Street
Hawley, MN 56549-0746
Mailing address
720 4TH St N
PO Box 2010
Fargo, ND 58122-0605
Phone (218) 483-3564
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 428716900 | Medicaid | MN |
Other names
- Sanford Hawley Clinic
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | Other |
Other providers in Hawley, MN
- Katlyn Olson
- Neha Patel
- Devon Pekas
- Nicole M. Perman
- Nicole Jean Reardon
- Sanford Medical Center Fargo
- Kaitlin Siewert
- Garrett Allen Skonseng
- Krista Southwick
- Shadaisa Dawn Stalberger
All providers in Hawley, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.