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Individual

CARY A GOTTLIEB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3401 LUDINGTON ST, ESCANABA, MI 49829-1300
(906) 226-9127
Mailing address
2837 US HIGHWAY 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964
(906) 226-3875

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301406387
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
220520070
BLUE CROSS BLUE SHIELD MI
MI
05
4194270
MI
Enumeration date
02/07/2006
Last updated
10/18/2007
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