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NPI Code Detail

MEDICARE: DR. MEGAN H LATHAM OD.

MEDICARE:  DR. MEGAN H LATHAM  OD.
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
1152W00000XOptometrist1912NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10922UOTHERNCBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003887274
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MEGAN H LATHAM OD.
Provider Business Mailing Address
First Line : 8614 WESTWOOD CENTER DR FL 9
Second Line :
City : VIENNA
State : VA
Zip : 22182-2442
Country : US
Telephone Number : 703-847-8899
Fax Number :
Provider Business Practice Location Address
First Line : 5100 HWY 70 WEST
Second Line :
City : MOREHEAD CITY
State : NC
Zip : 28557-4512
Country : US
Telephone Number : 252-727-5290
Fax Number : 252-727-0091
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2006
Last Update Date : 09/18/2024

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