Individual
RUTH CHRISTINA AURELIA LATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8220 MEADOWBRIDGE RD, SUITE 203, MECHANICSVILLE, VA 23116-2336
(804) 764-1253
(804) 764-1259
Mailing address
8220 MEADOWBRIDGE RD, SUITE 203, MECHANICSVILLE, VA 23116-2336
(804) 764-1253
(804) 764-1259
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101245954
VA
207Q00000X
Family Medicine Physician
2007-01497
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275712333
—
VA
01
—
C06115
GROUP PTAN
VA
Enumeration date
10/25/2007
Last updated
03/27/2013
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