Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301116039 | MI |
N | 208000000X | Pediatrician | MT203893 | PA |
Y | 2084N0402X | Child Neurologist | 4301116039 | MI |
NPI | 1134499668 |
---|---|
Provider Name | Rachel Jennifer Gottlieb-Smith |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2011 |
Last Update Date | 10/02/2020 |