Individual
MARC TRAVIS LATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4755 OGLETOWN STANTON RD, SUITE 1E50, NEWARK, DE 19718-2200
(302) 733-1980
(302) 733-1986
Mailing address
200 HYGEIA DR, SUITE 2300, NEWARK, DE 19713-2049
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-13626
NC
363A00000X
Physician Assistant
0110001154
VA
363A00000X
Physician Assistant
C5-0001013
DE
Other
Enumeration date
09/22/2006
Last updated
12/19/2024
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