Gautam Mukund Phadke (NPI# 1396997649, PAC ID# 2567631062) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NEPHROLOGY.
| Nation Provider ID (NPI) | 1396997649 |
| PAC ID by PECOS | 2567631062 |
| Professional Enrollment ID | I20110817000400 |
| Full Name | Gautam Mukund Phadke |
| Organization Legal Name | SANFORD CLINIC NORTH |
| Address |
336 Main St Forman ND 58032-0184 |
| Phone Number | 7017243221 |
| Gender | M |
| Graduation Year | 2001 |
| Primary Specialty | NEPHROLOGY |
| Secondary Specialties | INTERNAL MEDICINE |
| Group Practice PAC ID | 4284546151 |
| Number of Group Practice Members | 369 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 350011 | SANFORD MEDICAL CENTER FARGO |
| 240052 | LAKE REGION HEALTHCARE CORPORATION |
| 340113 | CAROLINAS MEDICAL CENTER/BEHAV HEALTH |
| 351329 | SANFORD HILLSBORO |
| 241373 | PERHAM HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 2711 Randolph Rd, Suite 400, Charlotte, NC 28207-2027 | 7043482992 | METROLINA NEPHROLOGY ASSOCIATES PA |
| 929 Central Ave Nw, East Grand Forks, MN 56721-1917 | 2187736800 | SANFORD CLINIC NORTH |
| 2400 32nd Ave S, Fargo, ND 58103-5800 | SANFORD CLINIC NORTH | |
| 2400 32nd Ave S, Fargo, ND 58103-5800 | SANFORD MEDICAL CENTER FARGO | |
| 2801 University Dr S, Fargo, ND 58103-6029 | 7012345673 | SANFORD MEDICAL CENTER FARGO |
| 5225 23rd Ave S, Fargo, ND 58104-7927 | 7014172575 | SANFORD MEDICAL CENTER FARGO |
| 736 Broadway N, Fargo, ND 58102-4421 | 7012342000 | SANFORD MEDICAL CENTER FARGO |
| 801 Broadway N, Fargo, ND 58102-3641 | SANFORD MEDICAL CENTER FARGO | |
| 336 Main St, Forman, ND 58032-0184 | 7017243221 | SANFORD CLINIC NORTH |
| 300 2nd Ave Ne, Jamestown, ND 58401-3373 | 7012516000 | SANFORD CLINIC NORTH |
| 1640 Campus Park Dr C, Monroe, NC 28112-5284 | 7042260366 | METROLINA NEPHROLOGY ASSOCIATES PA |
| 4000 28th S Ave, Moorhead, MN 56560-7926 | 2182337578 | SANFORD CLINIC NORTH |
| Organization Legal Name | SANFORD CLINIC NORTH |
| Physicians | 392 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sadie M Nelson | Nurse Practitioner | Sanford Clinic North | 801 Broadway N, Fargo, ND 58102-3641 |
| Jenna M Long | Nurse Practitioner | Sanford Clinic North | 100 St Ave Sw, Suite 2, Lamoure, ND 58458-7419 |
| Tamera A Ostenaa | Nurse Practitioner | Sanford Clinic North | 410 4th St Nw, Mahnomen, MN 56557-4208 |
| Daniel M Hoffman | Dermatology | Sanford Clinic North | 4656 40th Ave S, Fargo, ND 58104-4397 |
| Morgan R Rinke | Nurse Practitioner | Sanford Clinic North | 820 4th St N, Fargo, ND 58102-4539 |
| Mridu Gandhi | Family Medicine | Sanford Clinic North | 929 Central Ave Nw, East Grand Forks, MN 56721-1917 |
| Ashish V Regulagadda | Nephrology | Sanford Clinic North | 736 Broadway N, Fargo, ND 58122-4421 |
| Mackenze J Cimbura | Physical Therapy | Sanford Clinic North | 904 5th Ave Ne, Jamestown, ND 58401-3437 |
| Carrie L Holt | Nurse Practitioner | Sanford Clinic North | 108 Viking Ave W, Ulen, MN 56585-0024 |
| Tara R Mertz-hack | Family Medicine | Sanford Clinic North | 420 S 7th St, Oakes, ND 58474-2024 |
| Street Address |
336 MAIN ST |
| City | FORMAN |
| State | ND |
| Zip | 58032-0184 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Thomas Duffy | Optometry | 336 Main St, Ansonia, CT 06401-2303 | |
| Brenda R Reich | Physician Assistant | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| James M Gabriel | Nurse Practitioner | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Heather M Mattson | Physical Therapy | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Bonnie Lee Groth | Nurse Practitioner | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Robert P Ostmo | Family Medicine | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Amy M Heim | Nurse Practitioner | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Michael David Segal | Urology | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Brent M Buchholz | Physician Assistant | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Alan Beaulieu | Optometry | 336 Main St, Wakefield, MA 01880-5013 | |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stacey M Walton | Physician Assistant | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| Kathleen L Siedschlag | Physician Assistant | Sanford Clinic North | 336 Main St, Forman, ND 58032-0184 |
| City | FORMAN |
| Zip Code | 58032 |
| Specialty | NEPHROLOGY |
| City + Specialty | FORMAN + NEPHROLOGY |
Please comment or provide details below to improve the information on Gautam Mukund Phadke.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.