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1120 St Paul St Ground Level Baltimore MD 21202 | |
(410) 685-7790 | |
(410) 332-9988 |
Full Name | |
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Speciality | General Practice |
Location | 1120 St Paul St, Baltimore, Maryland |
Authorized Official Name and Position | Robert David Gober (OWNER) |
Authorized Official Contact | 4109080946 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1120 St Paul St B Ground Level Baltimore MD 21202 Ph: (410) 685-7790 | 1120 St Paul St Ground Level Baltimore MD 21202 Ph: (410) 685-7790 |
NPI Number | 1043418494 |
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Provider Enumeration Date | 07/06/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1043418494 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
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