Healthcare Provider Details

I. General information

NPI: 1952348930
Provider Name (Legal Business Name): SCOTT MICHAEL URBAN D,O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 11/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 PACIFIC AVE FL 8 EMERGENCY MEDICINE
ATLANTIC CITY NJ
08401-6713
US

IV. Provider business mailing address

1925 PACIFIC AVE FL 8 EMERGENCY MEDICINE
ATLANTIC CITY NJ
08401-6713
US

V. Phone/Fax

Practice location:
  • Phone: 609-441-8127
  • Fax:
Mailing address:
  • Phone: 609-441-8127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MB07391300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: