Edward Marvin Gotlieb MD

NPI 1093713356 - Pediatrics - 2080A0000X

NPI Details
NPI 1093713356
Gender Male
Enumeration Date 07/11/2005
Last Updated 09/28/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
5405 MEMORIAL DR
BUILDING D
STONE MOUNTAIN GA, 30083-3234, US
Phone (404) 296-3800
Fax (404) 297-8753
Business Location
5405 MEMORIAL DR
BUILDING D
STONE MOUNTAIN GA, 30083-3234, US
Phone (404) 296-3800
Fax (404) 297-8753
Toxanomy
Taxonomy Code 2080A0000X
License State Georgia
License Number 014500
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According to our database, Dr. Edward Marvin Gotlieb MD NPI is 1093713356, taxonomy code is 2080A0000X and license number is 014500, license state is located at Georgia. Edward Marvin Gotlieb MD physically located at 5405 Memorial Dr, Stone Mountain GA, 30083-3234. NPI Number Edward Marvin Gotlieb MD has the Individual type.

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1093713356 NPI number is provided on an as is basis without warranty of any kind. 1093713356 is maintained by the National Plan & Provider Enumeration System. The contents of Edward Marvin Gotlieb MD are for informational purposes only.