Individual
SERGIO A MENDOZA LATTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
40 DUKE MEDICINE CIR, CLINIC 1B/1C, DURHAM, NC 27710-4000
(919) 684-8111
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
(800) 782-6945
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
SP135
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0245662
—
IA
01
—
41986
WELLMARK BCBS
IA
Enumeration date
08/24/2005
Last updated
01/15/2015
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