Provider Demographics
NPI:1144292822
Name:LATIMER, KELLY MAYA (MD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:MAYA
Last Name:LATIMER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:825 FAIRFAX AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1914
Mailing Address - Country:US
Mailing Address - Phone:757-446-5955
Mailing Address - Fax:757-446-8450
Practice Address - Street 1:825 FAIRFAX AVE STE 118
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-5955
Practice Address - Fax:757-446-8450
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-06
Last Update Date:2025-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101223148207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine