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Licensee Information

Marc Travis Latta - PA-C
0010-13626
Active
No
09/27/2023
12/23/2026

Active Supervisor

NameTypeStatusApprovedInactive
Mannam, Praveen, MD MD Active 12/18/2024
Smith, James Patrick, MD MD Active 10/16/2024

North Carolina Hospital Admitting Privileges

Location
None Reported

Out of State Active/Inactive Licenses

State
Delaware
New Jersey
New York
Tennessee
Virginia

Out of Country Active/Inactive Licenses

Country
None Reported
Information loaded from this database is current as of 5/10/2026 4:12:29 PM
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