Sanford Medical Center Fargo

Organization End-Stage Renal Disease (ESRD) Treatment Clinic/Center · NPI 1578508198

Sanford Medical Center Fargo provides End-Stage Renal Disease (ESRD) Treatment Clinic/Center services in Detroit Lakes, Minnesota. Registered with an NPI since 2006.

In the registry since: 2006

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Practice location Address checks out

1234 Washington Ave Ste B
Detroit Lakes, MN 56501-3906
Phone: (218) 846-2200
Fax: (218) 846-2201

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

End-Stage Renal Disease (ESRD) Treatment Clinic/Center (primary)	Taxonomy 261QE0700X

Record details

NPI number	1578508198
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Tony Morrison — Vice President, Revenue Cycle · (605) 328-8380
Other names	Sanford Dialysis Detroit Lakes; Sanford Dialysis Detroit Lakes
NPI enumerated	June 18, 2006
Last updated in NPPES	July 2, 2020
Certification date	July 2, 2020
Mailing address	Po Box 2168, Fargo, ND 58107-2168

Clinicians affiliated with this facility

Clinicians the CMS Facility Affiliation file lists at this facility.

Mr. Mitchell Julius Likness, PA-C Physician Assistant · Fargo, ND
Jason Patrick Lizakowski, PA-C Physician Assistant · Fargo, ND
Ahmer H Qarni, MD Specialist · Fargo, ND
Eram Shahira, MD Internal Medicine Physician · Fargo, ND