| Doctor Name: | DR. ALEXANDRA LANDERS LATAILLE |
| NPI Number: | 1538549639 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 38229 |
| Business Practice Address: | 169 Ashley Ave Room 202 Main Hospital Msc 333 Charleston, SC - 294258905 |
| Business Phone Number: | 8437922437 |
| Business Fax Number: | |
| Mailing Address: | 169 Ashley Ave, Room 202 Main Hospital Msc 333 CHARLESTON |
| State: | SC |
| Postal Code: | 294258905 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/03/2015 |
| NPI Last Update Date: | 06/03/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 38229 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |