Provider Demographics
NPI:1972541050
Name:HUNTER, LATANYA DENISE (MD)
Entity type:Individual
Prefix:DR
First Name:LATANYA
Middle Name:DENISE
Last Name:HUNTER
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 1:500 J CLYDE MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1929
Mailing Address - Country:US
Mailing Address - Phone:757-594-2050
Mailing Address - Fax:
Practice Address - Street 1:3105 AMERICAN LEGION RD STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5653
Practice Address - Country:US
Practice Address - Phone:757-686-3999
Practice Address - Fax:757-686-3015
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101228019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5641420Medicaid
VA080008069Medicare ID - Type Unspecified
VA5641420Medicaid