# MARYLAND INTERVENTIONAL PAIN MANAGEMENT, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Baltimore Pain Relief Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568749125
- **Authorized official:** MR. TIMOTHY J GOBER DC (OWNER)
- **Authorized official phone:** (443) 725-4930

## Contact information

- **Practice address:** 5430 CAMPBELL BLVD, SUITE 106, WHITE MARSH, MD 21162-5500
- **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 | — |
| 207R00000X | Internal Medicine Physician | 73023 | MD | — |
| 208D00000X | General Practice Physician | 20215 | MD | — |
| 208D00000X | General Practice Physician | 60828 | MD | Yes |
| 363A00000X | Physician Assistant | 3824 | MD | — |
| 363A00000X | Physician Assistant | 3868 | MD | — |

## Other

- **Enumeration date:** 11/10/2011
- **Last updated:** 04/30/2012