Individual
LATISHA C MURRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3452 ANDERSON HWY, SUITE D, POWHATAN, VA 23139-5845
(804) 285-6050
(804) 598-2481
Mailing address
11761 ROCK LANDING DR, STE 8, NEWPORT NEWS, VA 23606-4235
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101258598
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C09633
GROUP PTAN
VA
Enumeration date
06/11/2012
Last updated
03/02/2022
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