Individual
DERRICK L LATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
10953
WV
207RN0300X
Nephrology Physician
35051747L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0077242000
—
WV
05
—
0344854
—
OH
01
—
10953B
HPUOV
WV
Enumeration date
03/29/2006
Last updated
03/06/2008
Update your record
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