Provider Demographics
NPI:1134481708
Name:MURRAY, LATISHA C (MD)
Entity Type:Individual
Prefix:
First Name:LATISHA
Middle Name:C
Last Name:MURRAY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11761 ROCK LANDING DR
Mailing Address - Street 2:STE 8
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4235
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8875
Practice Address - Street 1:3452 ANDERSON HWY
Practice Address - Street 2:SUITE D
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5845
Practice Address - Country:US
Practice Address - Phone:804-285-6050
Practice Address - Fax:804-598-2481
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2022-03-02
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Provider Licenses
StateLicense IDTaxonomies
VA0101258598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09633OtherGROUP PTAN