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General NPI Number Information
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NPI Number | 1780663658
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Entity Type | Individual
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Provider Name | LATTEE W CHINAKARN M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 04/06/2012
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Provider Practice Location Address
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Address Line | 1524 SUNSET BLVD SUITE B
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City | STEUBENVILLE
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State | OH
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Zip | 43952-1380
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Country | US
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Telephone | 740-282-9780
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Fax | 740-282-9750
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Provider Business Mailing Address
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Address Line | 1524 SUNSET BLVD SUITE B
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City | STEUBENVILLE
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State | OH
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Zip | 43952-1380
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Country | US
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Telephone | 740-282-9780
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Fax | 740-282-9750
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35048710C
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License Number State | OH
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