Provider Demographics
NPI:1902878499
Name:LATKOVICH, KATARINA (MD)
Entity type:Individual
Prefix:DR
First Name:KATARINA
Middle Name:
Last Name:LATKOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:12 HIGH ST
Mailing Address - Street 2:STE 400 CENTRAL MAINE INTERNAL MEDICINE
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240
Mailing Address - Country:US
Mailing Address - Phone:207-795-5700
Mailing Address - Fax:207-795-5727
Practice Address - Street 1:12 HIGH ST
Practice Address - Street 2:STE 400 CENTRAL MAINE INTERNAL MEDICINE
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240
Practice Address - Country:US
Practice Address - Phone:207-795-5700
Practice Address - Fax:207-795-5727
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME018602207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME001005401Medicare PIN