Provider Demographics
NPI:1740384056
Name:GOBERN, JOSEPH M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:M
Last Name:GOBERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE STE 661
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3437
Mailing Address - Country:US
Mailing Address - Phone:610-649-8085
Mailing Address - Fax:610-649-8984
Practice Address - Street 1:100 E LANCASTER AVE STE 661
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3437
Practice Address - Country:US
Practice Address - Phone:610-649-8085
Practice Address - Fax:610-649-8984
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461722207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology