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Individual

DR. LATA KONERU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
4218 PENRITH CT, DUBLIN, OH 43016-8276
(614) 566-5000
(888) 760-4007
Mailing address
4218 PENRITH CT, DUBLIN, OH 43016-8276
(614) 659-0500
(888) 760-4007

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35073328
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2093265
OH
01
SP00321
MEDICARE GROUP NUMBER
OH
Enumeration date
03/24/2006
Last updated
01/29/2013
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