# MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC
- **Other names:** BALTIMORE PAIN RELIEF CENTER
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053670430
- **Legal business name:** MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC
- **Authorized official:** MR. TIMOTHY J GOBER DC (PRESIDENT)
- **Authorized official phone:** (443) 725-4930

## Contact information

- **Practice address:** 1147 S HANOVER ST, BALTIMORE, MD 21230-3717
- **Practice address phone:** (443) 725-4930
- **Practice address fax:** (443) 725-4933
- **Mailing address:** 5430 CAMPBELL BLVD, SUITE 106, WHITE MARSH, MD 21162-5500
- **Mailing address phone:** (443) 725-4930
- **Mailing address fax:** (443) 725-4933

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 3470 | MD | — |
| 208D00000X | General Practice Physician | 60828 | MD | Yes |
| 363A00000X | Physician Assistant | 3825 | MD | — |
| 363A00000X | Physician Assistant | 3868 | MD | — |

## Other

- **Enumeration date:** 05/07/2012
- **Last updated:** 05/07/2012