Organization
WHITE MARSH HEALTHCARE PHYSICAL MEDICINE LLC
Active
Organization
WHITE MARSH HEALTHCARE PHYSICAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY GOBER (OWNER)
(443) 600-5807
Entity
Organization
Contact information
Practice address
5430 CAMPBELL BLVD., STE. 106, WHITE MARSH, MD 21162
(443) 600-5807
(443) 725-4933
Mailing address
5430 CAMPBELL BLVD., STE. 106, WHITE MARSH, MD 21162
(443) 725-4930
(443) 725-4933
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
03470
MD
111N00000X
Chiropractor
03606
MD
207R00000X
Internal Medicine Physician
MD20215
MD
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
208D00000X
General Practice Physician
D27411
MD
208VP0014X
Interventional Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
363A00000X
Physician Assistant
C3824
MD
363AM0700X
Medical Physician Assistant
C0000614
MD
Other
Enumeration date
10/15/2010
Last updated
08/10/2011
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