| Santoshi Lattupally, | |
|
103 Stuard St, Gaffney, SC 29341-1263 | |
| (864) 514-1080 | |
| (864) 514-1090 |
| Full Name | Santoshi Lattupally |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 103 Stuard St, Gaffney, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700308178 | NPI | - | NPPES |
| SCI785J577 | Other | SC | MEDICARE PIN |
| SCI7855019 | Other | SC | MEDICARE PIN |
| SCI7856084 | Other | SC | MEDICARE PIN |
| 847052 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 84705 (South Carolina) | Primary |
| Entity Name | Spartanburg Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235170077 PECOS PAC ID: 3072425297 Enrollment ID: O20040322000577 |
| Entity Name | Spartanburg Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699729939 PECOS PAC ID: 3072425297 Enrollment ID: O20040702000686 |
| Entity Name | Cherokee Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1285275305 PECOS PAC ID: 5991041212 Enrollment ID: O20191220002041 |
| Mailing Address | Practice Location Address |
|---|---|
| Santoshi Lattupally, Po Box 277723, Atlanta, GA 30384-3070 Ph: () - | Santoshi Lattupally, 103 Stuard St, Gaffney, SC 29341-1263 Ph: (864) 514-1080 |
Beverly Elizabeth Corry, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1621 W Buford St, Gaffney, SC 29341 Phone: 864-488-9247 | |
Dr. Roy Woodley Furr Jr., M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1307 N Logan St, Gaffney, SC 29341 Phone: 864-488-1333 |