Provider Demographics
NPI:1932140092
Name:GOBIN, MARK RICHARD (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:RICHARD
Last Name:GOBIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:920 DOUG WHITE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4181
Mailing Address - Country:US
Mailing Address - Phone:843-236-1950
Mailing Address - Fax:843-236-1952
Practice Address - Street 1:2900 12TH AVE N
Practice Address - Street 2:SUITE 160W
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-7506
Practice Address - Country:US
Practice Address - Phone:410-623-7850
Practice Address - Fax:406-237-8501
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT8728207R00000X
SC39792207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine