Provider Demographics
NPI:1881589406
Name:OBEN, GILBERT ETTA
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:ETTA
Last Name:OBEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 HENNEPIN CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1761
Mailing Address - Country:US
Mailing Address - Phone:301-326-5436
Mailing Address - Fax:
Practice Address - Street 1:7701 HENNEPIN CT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1761
Practice Address - Country:US
Practice Address - Phone:301-326-5436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator