Healthcare Provider Details
I. General information
NPI: 1134141609
Provider Name (Legal Business Name): RICHARD STEPHEN URBAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2006
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
990 HIGBEE DRIVE SUITE B102
BETHEL PARK PA
15102
US
IV. Provider business mailing address
990 HIGBEE DRIVE SUITE B102
BETHEL PARK PA
15102
US
V. Phone/Fax
- Phone: 412-835-8090
- Fax: 412-835-8044
- Phone: 412-835-8090
- Fax: 412-835-8044
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD024244E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: