Organization
LATHA MEDICAL PC
Active
Other names
METRO FAMILY CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THULASI SWARNA LATHA DIVI M.D. (PRESIDENT)
(313) 366-1115
Entity
Organization
Contact information
Practice address
19953 CONANT ST, DETROIT, MI 48234-1334
(313) 366-1115
(313) 366-1116
Mailing address
19953 CONANT ST, DETROIT, MI 48234-1334
(313) 366-1115
(313) 366-1116
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301062122
MI
Other
Enumeration date
08/10/2010
Last updated
08/10/2010
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