Healthcare Provider Details

I. General information

NPI: 1922064971
Provider Name (Legal Business Name): MARIA D URBAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 10/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE CHILDRENS PLAZA
DAYTON OH
45404
US

IV. Provider business mailing address

P O BOX 1144
DAYTON OH
45401
US

V. Phone/Fax

Practice location:
  • Phone: 937-641-3487
  • Fax: 937-641-5878
Mailing address:
  • Phone: 937-259-9900
  • Fax: 937-259-9999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35046615
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35046615
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: