Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 0101055434 | VA |
N | 208000000X | Pediatrician | 0101055434 | VA |
NPI | 1649264953 |
---|---|
Provider Name | Leigh A. Lather |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22903-2824 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 30/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1138T | BCBS NC (01) | NC |
891138T | (05) | NC |
G47103 | (02) | NC |