SHANTA GAUTHAM

GRAND FORKS, ND
NPI1851562375
Former NameSHANTA SUBRAMANIAN
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: ND  11672)
Enumeration Date2008-03-13
Last Update Date2019-03-05
Business Address
SHANTA GAUTHAM MD
725 HAMLINE ST - ALTRU FAMILY MEDICINE RESIDENCY
GRAND FORKS, ND 58203
Phone number: 701-780-6800
Mailing Address
SHANTA GAUTHAM MD
2401 DEMERS AVE
GRAND FORKS, ND 58201
Phone number: 701-780-1891
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