Healthcare Provider Details

I. General information

NPI: 1407854490
Provider Name (Legal Business Name): RAMSAY S KURBAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 10/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 NORMAN DR
LEBANON PA
17042-7445
US

IV. Provider business mailing address

845 NORMAN DR
LEBANON PA
17042-7445
US

V. Phone/Fax

Practice location:
  • Phone: 717-273-8091
  • Fax: 717-273-9081
Mailing address:
  • Phone: 717-273-8091
  • Fax: 717-273-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD043706L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberMD043706L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberMD043706L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: