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
Fax: (703) 689-4998
Website:

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073573382 NPPES
Virginia MEDICAID 01-00444448

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