Provider Demographics
NPI:1851274328
Name:HEMACHANDRA, THABREW LAHIRU ARUNA SHAN
Entity type:Individual
Prefix:
First Name:THABREW
Middle Name:LAHIRU ARUNA SHAN
Last Name:HEMACHANDRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 W MCDOWELL RD APT 1034
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-4970
Mailing Address - Country:US
Mailing Address - Phone:480-913-1082
Mailing Address - Fax:
Practice Address - Street 1:9250 N 3RD ST STE 3015
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2425
Practice Address - Country:US
Practice Address - Phone:480-867-7171
Practice Address - Fax:480-569-2865
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR82153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine