Gottlich, Malcolm D
Gottlich, Malcolm D is an individual health care provider with primary practice located at 1075 Mason Ave , Daytona Beach FL 32117. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Gottlich, Malcolm D can be contacted via phone (386) 255-4596.Contact Information
Primary practice address
1075 Mason Ave
Daytona Beach FL 32117
Phone: (386) 255-4596
Fax: (386) 258-3561
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | ME57439 | Florida |
Profile Details
| NPI number | 1639158538 |
|---|---|
| LBN Legal business name | Gottlich, Malcolm D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2006 |
| Last updated | Apr 23rd, 2013 - 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 | 1639158538 | NPPES |
| Florida | MEDICAID | 007653200 |
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