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621 Demers Ave East Grand Forks MN 56721-1833 | |
(218) 773-5800 | |
(218) 773-5888 |
Full Name | |
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Speciality | Family Medicine |
Location | 621 Demers Ave, East Grand Forks, Minnesota |
Authorized Official Name and Position | Martha K Leclerc (VP) |
Authorized Official Contact | 7012346248 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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621 Demers Ave East Grand Forks MN 56721-1833 Ph: (218) 773-5800 | 621 Demers Ave East Grand Forks MN 56721-1833 Ph: (218) 773-5800 |
NPI Number | 1013952605 |
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Provider Enumeration Date | 06/18/2006 |
Last Update Date | 11/27/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013952605 | NPI | - | NPPES |
398687000 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Healthy Happy Whole, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 406 3rd St Nw, East Grand Forks, MN 56721 Phone: 989-720-4325 | |
Riverview Healthcare Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1428 Central Ave Ne, East Grand Forks, MN 56721 Phone: 866-773-1390 | |