| Red River Family Medicine, Pc | |
|
300 Main Ave Suite 200 Fargo ND 58103-1930 | |
| (701) 499-4340 | |
| (701) 499-4341 |
| Full Name | Red River Family Medicine, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 300 Main Ave, Fargo, North Dakota |
| Authorized Official Name and Position | Shantell Marie Twobears (PRESIDENT) |
| Authorized Official Contact | 7014994340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Red River Family Medicine, Pc 300 Main Ave Suite 200 Fargo ND 58103-1930 Ph: (701) 499-4340 | Red River Family Medicine, Pc 300 Main Ave Suite 200 Fargo ND 58103-1930 Ph: (701) 499-4340 |
| NPI Number | 1831312750 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 08/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831312750 | NPI | - | NPPES |
| 931G4RE | Other | MN | BLUE CROSS BLUE SHIELD |
| 98-98110 | Other | MEDICA | |
| 13172 | Other | HEALTHPARTNERS | |
| 14245 | Medicaid | ND | |
| 06960/001 | Other | ND | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 7807 (North Dakota) | Primary |
| 363LF0000X | Nurse Practitioner - Family | R28446 (North Dakota) | Secondary |
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