Individual
MARC E GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1012 E WILLETTA STREET, PHOENIX, AZ 85006
(602) 839-6040
(602) 839-4375
Mailing address
1012 E WILLETTA STREET, PHOENIX, AZ 85006
(602) 839-6040
(602) 839-4375
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
20039
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
053025
—
AZ
Enumeration date
10/10/2005
Last updated
07/01/2016
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