Organization
MARC E GOTTLIEB MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC E GOTTLIEB MD (PHYSICIAN OWNER)
(602) 252-3354
Entity
Organization
Contact information
Practice address
1012 E WILLETTA ST, PHOENIX, AZ 85006-2749
(602) 239-6040
(602) 252-2367
Mailing address
PO BOX 86040, PHOENIX, AZ 85080-6040
(602) 252-3354
(602) 252-2367
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
11/09/2009
Last updated
11/09/2009
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