Individual
LATHA VENKATESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1010 REMINGTON PLZ, RAYMORE, MO 64083-8640
(888) 403-1071
Mailing address
3801 BLUE PKWY, KANSAS CITY, MO 64130-2807
(816) 923-2500
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R7J41
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202992350
—
MO
Enumeration date
06/30/2005
Last updated
02/28/2019
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