Healthcare Provider Details

I. General information

NPI: 1568646834
Provider Name (Legal Business Name): DAVID M. URBANSKI, M.D., PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2007
Last Update Date: 10/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1683 LITTLESTONE RD
GROSSE POINTE WOODS MI
48236-1954
US

IV. Provider business mailing address

1683 LITTLESTONE RD
GROSSE POINTE WOODS MI
48236-1954
US

V. Phone/Fax

Practice location:
  • Phone: 331-388-5604
  • Fax: 313-417-2473
Mailing address:
  • Phone: 331-388-5604
  • Fax: 313-417-2473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number4301050733
License Number StateMI

VIII. Authorized Official

Name: DR. DAVID M. URBANSKI
Title or Position: OWNER
Credential: M.D.
Phone: 313-885-6049