SHANTA GAUTHAM


Address: 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203
Phone: 7017806800

SHANTA GAUTHAM (NPI# 1851562375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851562375
Entity Type Individual
Full Name SHANTA GAUTHAM
Other Name SHANTA SUBRAMANIAN
Credential MD
Practice Address 725 Hamline St - Altru Family Medicine Residency
Grand Forks
ND 58203
Mailing Address 2401 Demers Ave
Grand Forks
ND 58201
Practice Telephone 7017806800
Practice Fax Number 7817445358
Mailing Telephone 7017801891
Mailing Fax Number 7817445358
Enumeration Date 2008-03-13
Last Update Date 2019-03-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine 11672 ND Allopathic & Osteopathic Physicians

Office Location

Street Address 725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY
City GRAND FORKS
State ND
Zip Code 58203

Providers in the same location

NPI Name Taxonomy Address Enumeration
1497833933 Casey J Ryan Internal Medicine 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2006-11-01
1124557566 Laura Morgan Family Medicine 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2017-06-08
1881094837 Sarah Kuster Dietitian, Registered 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2014-08-27
1811311814 Sara Mutzenberger Dietitian, Registered 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2014-02-11
1619258951 Jana Kaye Sherry Registered Nurse 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2011-08-31
1700011459 Andrew V Gasparini Family Medicine 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2009-05-26
1821261256 Sara Nausheen Internal Medicine 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2008-04-07
1396948493 Lynn M Holum Dietitian, Registered 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2007-06-06
1750584850 Susan Marie Streitz Dietitian, Registered 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2007-06-06
1922201029 Danika Ann Warner Noreen Dietitian, Registered 725 Hamline St - Altru Family Medicine Residency, Grand Forks, ND 58203 2007-06-06
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326354978 Valley Med Flight Inc Ambulance 2403 Air Cargo Dr, Grand Forks, ND 58203 2010-08-20
1285842765 Amanda Caroline Ostlie Physical Therapy Assistant 1809 5th Ave N, Grand Forks, ND 58203 2007-05-18
1346396314 Carla Steen Speech-Language Pathologist 501 N Columbia Rd Stop 8040, Grand Forks, ND 58203 2007-01-25
1457408239 Rebecca Ann Westereng Dietitian, Registered 725 Hamline St Altru Family Medicine Residency, Grand Forks, ND 58203 2007-01-04
1912063587 Northridge Counseling Centre Inc Counselor 215 N 3rd Street, Suite 202a, Grand Forks, ND 58203 2006-12-28
1245318625 Charles Lee Bridgeford Dentist 117 North Washington Street, Grand Forks, ND 58203 2006-11-01
1033217955 Diane Kay Baumbach Social Worker 2755 10th Ave N, Grand Forks, ND 58203 2006-09-21
1841217320 Heidi J Philpot Family Medicine 725 Hamline Street, Grand Forks, ND 58203 2006-07-17
1902415805 Aura Patricia Ileto Azarcon Student in an Organized Health Care Education/Training Program 725 Hamline Street, Altru Family Medicine Residency, Grand Forks, ND 58203 2020-07-27
1023626462 Gianfranco Tarsitano Family Medicine 725 Hamline Street, Grand Forks, ND 58203 2020-07-22
Find all providers in zip 58203

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821307539 Harold Warren Evans Internal Medicine 293 Circle Hills Drive, Grand Forks, ND 58201-7958 2010-09-29
1023295300 Marcin Szember Internal Medicine 4440 S. Washington St. - Altru Professional Center, Grand Forks, ND 58201-7245 2008-01-29
1730387606 Laura Ann Lizakowski Internal Medicine 1200 South Columbia Rd - Altru Hospital, Grand Forks, ND 58201 2007-07-03
1063503423 Leslie M Klevay Internal Medicine Und Box 9037 Ppt, Grand Forks, ND 58201 2006-09-28
1811088602 Jon W Allen Internal Medicine 501 N Columbia Rd, Grand Forks, ND 58202-6094 2006-09-27
1326064817 Rene' D. Fredstrom Internal Medicine 1200 S Columbia Rd - Altru Health System, Grand Forks, ND 58201 2006-07-15
1285636423 Kirsten D Peterson Internal Medicine 1000 S Columbia Rd, Grand Forks, ND 58201-4032 2005-06-01
1629637624 Rachel Busko Internal Medicine 725 Hamline St, Grand Forks, ND 58203-2819 2019-06-12
1437505245 Kenneth Aduba Internal Medicine 1200 S Columbia Rd- Altru Hospital, Grand Forks, ND 58201 2016-05-11
1659725752 Nicholas Bennett Internal Medicine 1200 S Columbia Rd- Altru Hospital, Grand Forks, ND 58201-4036 2016-04-15
Find all providers in GRAND FORKS

Competitor

Search similar providers

City GRAND FORKS
Zip Code 58203

Improve Information

Please comment or provide details below to improve the information on SHANTA GAUTHAM.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches