Healthcare Provider Details

I. General information

NPI: 1801587233
Provider Name (Legal Business Name): VALERIE URBAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 WOODLAND DR
SALINE MI
48176-1620
US

IV. Provider business mailing address

1522 SIMPSON ROAD EAST ROOM D3202
ANN ARBOR MI
48109-5718
US

V. Phone/Fax

Practice location:
  • Phone: 734-539-5080
  • Fax:
Mailing address:
  • Phone: 734-647-1774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351050568
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: