Provider Demographics
NPI:1467522623
Name:GOBER, HENRY FRED JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:FRED
Last Name:GOBER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5505 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 580
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1705
Mailing Address - Country:US
Mailing Address - Phone:404-256-6336
Mailing Address - Fax:
Practice Address - Street 1:5505 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 580
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1705
Practice Address - Country:US
Practice Address - Phone:404-256-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA20432207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4030890OtherAETNA MANAGED CHOICE
GA57715OtherUSA HEALTH NETWORK
GAZZFS1020431OtherCHAMPUS
GA468076OtherAETNA
GA662683OtherHEALTH FIRST
GA4030890OtherAETNA MANAGED CHOICE