Gottlieb, Wendy Ruth
Gottlieb, Wendy Ruth is an sole proprietor health care provider with primary practice located at 1800 Town Center Dr Suite 418, Reston VA 20190-3215. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Gottlieb, Wendy Ruth can be contacted via phone (703) 668-9499.Contact Information
Primary practice address
1800 Town Center Dr Suite 418
Reston VA 20190-3215
Phone: (703) 668-9499
Fax: (703) 689-4998
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 0101231213 | Virginia |
Profile Details
| NPI number | 1073573382 |
|---|---|
| LBN Legal business name | Gottlieb, Wendy Ruth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Nov 12th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073573382 | NPPES |
| Virginia | MEDICAID | 01-00444448 |
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