DR. EDWARD MARVIN GOTLIEB MD NPI 1093713356

NPI Information

  • NPI: 1093713356
  • Provider Name: DR. EDWARD MARVIN GOTLIEB, MD
  • Classification: Pediatrics - 2080A0000X
  • Specialization: Adolescent Medicine
  • Entity Type: Individual
  • Address: 5405 MEMORIAL DR
    BUILDING D
    STONE MOUNTAIN, GA
    ZIP 30083
  • Phone: (404) 296-3800

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NPI Details

DR. Edward Marvin Gotlieb, MD is an adolescent medicine pediatrics in Stone Mountain, GA. The provider is a pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. DR. Edward Marvin Gotlieb, MD NPI is 1093713356. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

5405 MEMORIAL DR
BUILDING D
STONE MOUNTAIN, GA
ZIP 30083-234
Phone: (404) 296-3800
Fax: (404) 297-8753

The enumeration date for this NPI number is 7/11/2005 and was last updated on 9/28/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080A0000XPediatricsAdolescent Medicine014500GEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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