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Individual

BRUCE BRYON LATHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
877 W FARIS RD, SUITE D, GREENVILLE, SC 29605-4254
(864) 455-9031
(864) 455-9014
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6306

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
14072
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
140724
SC
01
P00802354
RR MEDICARE
SC
Enumeration date
05/18/2006
Last updated
07/21/2022
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