Provider Demographics
NPI:1972978153
Name:GANTI, SHANKAR UMA (MD)
Entity type:Individual
Prefix:
First Name:SHANKAR
Middle Name:UMA
Last Name:GANTI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:157 BALTIMORE ST SUITE 102
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502
Mailing Address - Country:US
Mailing Address - Phone:301-722-0484
Mailing Address - Fax:833-903-0130
Practice Address - Street 1:1507 S TUTTLE AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2608
Practice Address - Country:US
Practice Address - Phone:301-722-0484
Practice Address - Fax:833-903-0130
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2025-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY156993-1208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine