Individual
DR. SCOTT LAWRENCE GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 GORDON DR, EXTON, PA 19341-1252
(610) 594-6660
(610) 594-6810
Mailing address
501 GORDON DRIVE, EXTON, PA 19341-1252
(610) 594-6660
(610) 594-6810
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
BG5778379
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0584421000
INDEPENDENCE BLUE CROSS
PA
01
—
070015815
RAILROAD MEDICARE
PA
01
—
2333525
AETNA HEALTH PLANS
PA
01
—
278650
PENNSYLVANIA BLUE SHIELD
PA
Enumeration date
03/22/2006
Last updated
05/14/2008
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