Provider Demographics
NPI:1861497331
Name:LATIF, RHONDA C (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:C
Last Name:LATIF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3747 ROSWELL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6227
Mailing Address - Country:US
Mailing Address - Phone:770-980-1818
Mailing Address - Fax:770-980-1873
Practice Address - Street 1:3747 ROSWELL RD STE 206
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062
Practice Address - Country:US
Practice Address - Phone:770-980-1818
Practice Address - Fax:770-980-1873
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030127207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00445134Medicaid
GA00445134Medicaid
GAE72635Medicare UPIN