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Individual
MARQUIS LATRELL JESSIE
Active
Individual
MARQUIS LATRELL JESSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
A91999
CA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
0101250972
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A91999
LICENSE
CA
Enumeration date
04/17/2007
Last updated
03/07/2023
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