Basic Information
| Provider Information | |||||||||
| NPI: | 1891714259 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NARASIMHAN | ||||||||
| FirstName: | SHANTI | ||||||||
| MiddleName: | LAKSHMI | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2450 RIVERSIDE AVE | ||||||||
| Address2: | UNIVERSITY OF MINNESOTA PHYSICIANS | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 55454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6126262755 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2450 RIVERSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554541450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123656777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 08/06/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 43350 | MN | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0202X | 43350 | MN | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 25-01616 | 01 | MN | MEDICA CHOICE | OTHER | 34552400 | 05 | WI | MEDICAID | 151087 | 01 | MN | UCARE | OTHER | HP49166 | 01 | MN | HEALTHPARTNERS | OTHER | 0078370 | 05 | MT | MEDICAID | 2267971 | 01 | MN | ARAZ | OTHER | 25-00282 | 01 | MN | MEDICA PRIMARY | OTHER | 834630500 | 05 | MN | MEDICAID | 1042473 | 01 | MN | PREFERRED ONE | OTHER |