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Individual

DEVRAJ LATH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBBS

Contact information

Practice address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-6500
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-6500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT230599
PA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MT230599
PA

Other

Enumeration date
07/15/2024
Last updated
07/27/2024
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