Basic Information
Provider Information
NPI: 1104082841
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LODHA
FirstName: SAMEER
MiddleName: JAGAN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 660 GOLDEN RIDGE RD
Address2: STE. 250
City: GOLDEN
State: CO
PostalCode: 804019541
CountryCode: US
TelephoneNumber: 3032331223
FaxNumber: 3032338755
Practice Location
Address1: 660 GOLDEN RIDGE RD
Address2: STE. 250
City: GOLDEN
State: CO
PostalCode: 804019541
CountryCode: US
TelephoneNumber: 3032331223
FaxNumber: 3032338755
Other Information
ProviderEnumerationDate: 08/01/2008
LastUpdateDate: 01/02/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X51759CON Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106X51759COY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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