Individual
DR. STEPHEN S GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8788
(410) 328-1048
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-8788
(410) 328-1048
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D36885
MD
207RI0011X
Interventional Cardiology Physician
D36885
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0195000000
—
WV
05
—
034324800
—
DC
05
—
1306808894
—
DE
05
—
2292068
—
OH
05
—
294261500
—
MD
01
—
529997-01
BLUE CROSS/BLUE SHIELD
MD
05
—
5849721
—
VA
Enumeration date
04/03/2006
Last updated
11/19/2010
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