Healthcare Provider Details

I. General information

NPI: 1932289436
Provider Name (Legal Business Name): GEORGE EDWARD URBAN JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 04/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 ALLENTOWN RD SUITE 209
CAMP SPRINGS MD
20746-4563
US

IV. Provider business mailing address

8116 GOOD LUCK RD SUITE 205
LANHAM MD
20706-3502
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-5500
  • Fax: 301-552-6866
Mailing address:
  • Phone: 301-552-5500
  • Fax: 301-552-6866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberD0012291
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: