Provider Demographics
NPI:1811290877
Name:LOTUS GROUP
Entity type:Organization
Organization Name:LOTUS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JHAVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-855-3229
Mailing Address - Street 1:1900 W FRYE RD
Mailing Address - Street 2:#1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6235
Mailing Address - Country:US
Mailing Address - Phone:480-855-3229
Mailing Address - Fax:480-855-3209
Practice Address - Street 1:1900 W FRYE RD
Practice Address - Street 2:#1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6235
Practice Address - Country:US
Practice Address - Phone:480-855-3229
Practice Address - Fax:480-855-3209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty