Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1912 | NC |
NPI | 1003887274 |
---|---|
Provider Name | Dr. Megan H Latham |
First Address | Morehead City, NC 28557-4504 |
Second Address | Morehead City, NC 28557-4512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 25/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0922U | BLUE CROSS BLUE SHIELD (01) | NC |
89093P8 | (05) | NC |
U72217 | (02) | NC |