Organization · Type 2 NPI

Sanford Medical Center Fargo

Rural Health Clinic/Center · Mahnomen, MN

NPI number 1831131234 Active

Practice location

410 4th St NW
Mahnomen, MN 56557-4208

Call (218) 935-2514 Map

Fax (218) 935-2720

Mailing address

PO Box 2168
Fargo, ND 58107-2168

Specialties and licenses

Taxonomy	Code	License
Family Medicine Physician	207Q00000X	None listed
Internal Medicine Physician	207R00000X	None listed
Obstetrics & Gynecology Physician	207V00000X	None listed
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

4 other providers at this address

Other rural health clinic/center providers in Mahnomen

St. Mary's Regional Health CenterRural Health Clinic/Center Mahnomen, MN NPI 1750725586

See all in Mahnomen →

NPI record

NPI: 1831131234
Entity type: Organization (Type 2)
Issued: Jun 11, 2006
Last updated: Nov 29, 2022
Status: Active

Other names

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Sanford Health Mahnomen Clinic · doing business as
Sanford Health Mahnomen Clinic · doing business as

Authorized official

Tony Lee Morrison
Vice President, Revenue Cycle
(605) 328-8380

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1831131234

Sanford Medical Center Fargo's National Provider Identifier is 1831131234, issued on Jun 11, 2006. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Mahnomen, MN. The record was last updated on Nov 29, 2022.