Healthcare Provider Details

I. General information

NPI: 1588649487
Provider Name (Legal Business Name): BARBARA P. URBAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 HOSPITAL DR SUITE B100
GLEN BURNIE MD
21061-6904
US

IV. Provider business mailing address

PO BOX 64577
BALTIMORE MD
21264-4577
US

V. Phone/Fax

Practice location:
  • Phone: 410-553-8351
  • Fax: 410-553-8352
Mailing address:
  • Phone: 443-462-5010
  • Fax: 410-684-2031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD50872
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: