DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. EDWARD MARVIN GOTLIEB, MD

Active

DR. EDWARD MARVIN GOTLIEB, MD is a Adolescent Medicine (Pediatrics) healthcare provider located in STONE MOUNTAIN, Georgia. NPI 1093713356 is currently active in the NPPES registry. Verify at CMS.

Adolescent Medicine (Pediatrics) · STONE MOUNTAIN, GA

Registration Details

NPI Number
1093713356
Provider Type
Individual
Gender
Male
NPI Issued
Jul 11, 2005 (21.074761679266 yrs)
Last Updated
Sep 28, 2011
License
014500 (GA)

Practice Information

Address
5405 MEMORIAL DR
BUILDING D
STONE MOUNTAIN, GA, 300833234
Browse GA providers · Browse ZIP 30083
Phone
4042963800
Fax
4042978753
Primary Specialty
Adolescent Medicine (Pediatrics)
2080A0000X

Other Adolescent Medicine (Pediatrics) Providers in STONE MOUNTAIN, GA

Name Credential NPI
MS. ANNE MICHELE BENFORD NP 1831843499
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.