MEDICARE: DANIEL EDWARD LATTIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	MD00020383	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720085947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL EDWARD LATTIN M.D.

Provider Business Mailing Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	#117
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-483-9419
Fax Number	:	509-483-7344

Provider Business Practice Location Address
First Line	:	5901 N LIDGERWOOD ST
Second Line	:	#117
City	:	SPOKANE
State	:	WA
Zip	:	99208-1122
Country	:	US
Telephone Number	:	509-483-9419
Fax Number	:	509-483-7344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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