Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 0101023974 | VA |
NPI | 1063522290 |
---|---|
Provider Name | Dr. Peter C Latkin |
First Address | Falls Church, VA 22044 |
Second Address | Falls Church, VA 22044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 04/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6756166 | (05) | VA |
B93937 | (02) | VA |