Sanford Medical Center Fargo

Organization Active NPI Family Medicine Physician · Hawley, MN

NPI 1861772162 · NPPES record last updated Nov 27, 2023

Key facts

NPI
1861772162
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
SANFORD MEDICAL CENTER FARGO
Practice address
1412 Main Street
Hawley, MN 56549-0746
Phone
(218) 483-3564
NPI assigned
Aug 18, 2011
Organization subpart
No

Authorized official

Name
Martha Leclerc
Title
Vice President
Phone
(701) 234-6248

Corporate family (same tax ID) 14

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Bemidji Same Day Surgery (71 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X

Addresses

Primary practice location

1412 Main Street
Hawley, MN 56549-0746

Mailing address

1412 Main Street
PO Box 746
Hawley, MN 56549-0746
Phone (218) 483-3564

Other names

  • Sanford Hawley Clinic Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other

Other providers in Hawley, MN

All providers in Hawley, MN · Family Medicine Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.