Healthcare Provider Details

I. General information

NPI: 1366803926
Provider Name (Legal Business Name): RICHARD ALAN URBANSKI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2016
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MARKET ST
BOARDMAN OH
44512-6725
US

IV. Provider business mailing address

9190 SPRINGFIELD RD APT. 3B
POLAND OH
44514-3105
US

V. Phone/Fax

Practice location:
  • Phone: 330-729-8757
  • Fax:
Mailing address:
  • Phone: 412-889-0469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number58.007462
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number83137
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: