Provider Demographics
NPI:1588305635
Name:SANTHANA, VELARCHANA SANGAMI (MD)
Entity type:Individual
Prefix:
First Name:VELARCHANA
Middle Name:SANGAMI
Last Name:SANTHANA
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 1:18484 KACHINA CT
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-4886
Mailing Address - Country:US
Mailing Address - Phone:952-993-8800
Mailing Address - Fax:
Practice Address - Street 1:18484 KACHINA CT
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-4886
Practice Address - Country:US
Practice Address - Phone:952-993-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN79868208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program