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Organization

MD2U NORTH CAROLINA LLC

Active
Parent organization
MD2U MANAGEMENT LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
MD2U MANAGEMENT LLC
Authorized official
GREGORY DAVID LATTA (CIO)
(502) 416-1851
Entity
Organization

Contact information

Practice address
228 WESTINGHOUSE BLVD STE 104, CHARLOTTE, NC 28273-6246
(502) 327-9100
(855) 632-8329
Mailing address
140 WHITTINGTON PKWY STE 100, LOUISVILLE, KY 40222-4930
(502) 327-9100
(855) 632-8329

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
09/12/2012
Last updated
09/12/2012
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