Sanford Medical Center Fargo
Organization Active NPI Pediatrics Physician · Fargo, ND
NPI 1942580246 · NPPES record last updated Nov 27, 2023
Key facts
- NPI
- 1942580246
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- SANFORD MEDICAL CENTER FARGO
- Practice address
- 2701 13TH Ave S
Fargo, ND 58103-3602 - Phone
- (701) 234-3600
- 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
National Provider Directory
- Tax ID family
- Bemidji Same Day Surgery
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
2701 13TH Ave S
Fargo, ND 58103-3602
Mailing address
2701 13TH Ave S
Fargo, ND 58103-3602
Phone (701) 234-3600
Other names
- Sanford Children's Southwest 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 Fargo, ND
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- Heidi Sanger
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All providers in Fargo, ND · Pediatrics Physician in North Dakota
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.