Individual
MICHELE J. GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-5500
(508) 481-3706
Mailing address
24 NEWTON ST, SOUTHBOROUGH, MA 01772-1215
(508) 481-5500
(508) 481-3706
Taxonomy
Speciality
Code
Description
License number
State
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
74250
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3111873
—
MA
Enumeration date
07/15/2006
Last updated
01/07/2013
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