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Individual

SANTOSHI LATTUPALLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
103 STUARD ST, GAFFNEY, SC 29341-1263
(864) 514-1080
(864) 514-1090
Mailing address
PO BOX 277723, ATLANTA, GA 30384-3070

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
84705
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
847052
SC
01
SCI7855019
MEDICARE PIN
SC
01
SCI7856084
MEDICARE PIN
SC
01
SCI785J577
MEDICARE PIN
SC
Enumeration date
07/07/2017
Last updated
07/15/2021
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