| Red River Neurology Clinic | |
|
2812 17th Ave S Ste D Grand Forks ND 58201-4048 | |
| (701) 780-1401 | |
| (701) 780-1404 |
| Full Name | Red River Neurology Clinic |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2812 17th Ave S, Grand Forks, North Dakota |
| Authorized Official Name and Position | Lorae Benson (MANAGER) |
| Authorized Official Contact | 7017801401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Red River Neurology Clinic 2812 17th Ave S Ste D Grand Forks ND 58201-4048 Ph: (701) 780-1401 | Red River Neurology Clinic 2812 17th Ave S Ste D Grand Forks ND 58201-4048 Ph: (701) 780-1401 |
| NPI Number | 1255337861 |
|---|---|
| Provider Enumeration Date | 06/28/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255337861 | NPI | - | NPPES |
| 16549 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 4231 (North Dakota) | Primary |
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