Ivery, Latonja M.
Ivery, Latonja M. is an individual health care provider with primary practice located at 1001 Stadium Drive Ste 104, Wake Forest NC 27587. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Ivery, Latonja M. can be contacted via phone (919) 623-5939.Contact Information
Primary practice address
1001 Stadium Drive Ste 104
Wake Forest NC 27587
Phone: (919) 623-5939
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2004-01519 | North Carolina |
Profile Details
| NPI number | 1699824607 |
|---|---|
| LBN Legal business name | Ivery, Latonja M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Jun 27th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699824607 | NPPES |
| North Carolina | MEDICAID | 5900011 |
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