Basic Information
Provider Information
NPI: 1972945269
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VARMA
FirstName: LAVANYA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3033 N CENTRAL AVE STE 145
Address2:  
City: PHOENIX
State: AZ
PostalCode: 850122808
CountryCode: US
TelephoneNumber: 6235863300
FaxNumber: 6239746721
Practice Location
Address1: 15525 N 83RD AVE STE 104
Address2:  
City: PEORIA
State: AZ
PostalCode: 853825820
CountryCode: US
TelephoneNumber: 8778095092
FaxNumber: 6235053727
Other Information
ProviderEnumerationDate: 07/26/2013
LastUpdateDate: 10/21/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X51582AZY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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