Individual
DR. EDWARD MARVIN GOTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5405 MEMORIAL DR, BUILDING D, STONE MOUNTAIN, GA 30083-3234
(404) 296-3800
(404) 297-8753
Mailing address
5405 MEMORIAL DR, BUILDING D, STONE MOUNTAIN, GA 30083-3234
(404) 296-3800
(404) 297-8753
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
014500
GA
Other
Enumeration date
07/11/2005
Last updated
09/28/2011
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