Healthcare Provider Details

I. General information

NPI: 1295846962
Provider Name (Legal Business Name): DAVID RALPH URBACH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 TER HEUN DRIVE SUITE 300
FALMOUTH MA
02540
US

IV. Provider business mailing address

90 TER HEUN DRIVE SUITE 300
FALMOUTH MA
02540
US

V. Phone/Fax

Practice location:
  • Phone: 508-540-0604
  • Fax: 508-457-0129
Mailing address:
  • Phone: 508-540-0604
  • Fax: 508-457-0129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number47033
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: