Latha Medical PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301062122 Issued in MI

Legal business name

LATHA MEDICAL PC

Practice address

19953 Conant St
Detroit, MI 48234-1334

Phone

(313) 366-1115

Fax

(313) 366-1116

NPI assigned

Aug 10, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Thulasi Swarna Latha Divi, M.D.

Title

President

Phone

(313) 366-1115

Specialties & licenses 1

Addresses

Other names 1

• METRO FAMILY CLINIC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281398400000",
    "number": "1699080002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19953 CONANT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341334",
            "telephone_number": "313-366-1115",
            "fax_number": "313-366-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19953 CONANT ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341334",
            "telephone_number": "313-366-1115",
            "fax_number": "313-366-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATHA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-10",
        "last_updated": "2010-08-10",
        "status": "A",
        "authorized_official_last_name": "DIVI",
        "authorized_official_first_name": "THULASI",
        "authorized_official_middle_name": "SWARNA LATHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-366-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301062122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "METRO FAMILY CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Glenda Laster
• Chona Bacay Lastimosa, M.D.
• Linda I Laszlo, CRNA
• Celest Latcha
• Vanika Lath, MD
• Angela Renee Latham, RN
• Antwayettae Concietta Latham
• Nafisa Latif, PA-C, R.D., C.D.E.
• Megan Latimer
• Latino Family Services

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.