Individual
DERRICK L LATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
58 16TH ST, SUITE 500, WHEELING, WV 26003-3660
(304) 242-7751
(304) 242-7254
Mailing address
58 16TH ST, SUITE 500, WHEELING, WV 26003-3660
(304) 242-7751
(304) 242-7254
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
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