Provider Demographics
NPI:1679658405
Name:GOBER, TIMOTHY (DC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:GOBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5430 CAMPBELL BOULEVARD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21236
Mailing Address - Country:US
Mailing Address - Phone:443-725-4930
Mailing Address - Fax:443-725-4933
Practice Address - Street 1:5430 CAMPBELL BOULEVARD
Practice Address - Street 2:SUITE 106
Practice Address - City:WHITE MARSH
Practice Address - State:MD
Practice Address - Zip Code:21236
Practice Address - Country:US
Practice Address - Phone:443-725-4930
Practice Address - Fax:443-725-4933
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03470111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor