Provider Demographics
NPI:1891714259
Name:NARASIMHAN, SHANTI LAKSHMI (MD)
Entity type:Individual
Prefix:DR
First Name:SHANTI
Middle Name:LAKSHMI
Last Name:NARASIMHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE
Mailing Address - Street 2:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454
Mailing Address - Country:US
Mailing Address - Phone:612-626-2755
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-365-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43350208000000X, 2080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN25-01616OtherMEDICA CHOICE
WI34552400Medicaid
MN151087OtherUCARE
MNHP49166OtherHEALTHPARTNERS
MT0078370Medicaid
MN2267971OtherARAZ
MN25-00282OtherMEDICA PRIMARY
MN834630500Medicaid
MN1042473OtherPREFERRED ONE
MN834630500Medicaid
MN1042473OtherPREFERRED ONE