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NPI Code Detail

MEDICARE: CARY A GOTTLIEB M.D.

MEDICARE: CARY A GOTTLIEB M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician4301406387MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2220520070OTHERMIBLUE CROSS BLUE SHIELD MI

General Provider Information

NPI Number : 1649242124
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARY A GOTTLIEB M.D.
Provider Business Mailing Address
First Line : 2837 US HIGHWAY 41 W
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-2252
Country : US
Telephone Number : 906-225-3964
Fax Number : 906-226-3875
Provider Business Practice Location Address
First Line : 3401 LUDINGTON ST
Second Line :
City : ESCANABA
State : MI
Zip : 49829-1300
Country : US
Telephone Number : 906-226-9127
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 10/18/2007

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Directions to “ CARY A GOTTLIEB M.D.” Practice Location

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