Provider Demographics
NPI:1104832005
Name:URBANIC, ROBERT CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CHARLES
Last Name:URBANIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 W ANN ARBOR TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-6204
Mailing Address - Country:US
Mailing Address - Phone:734-455-4200
Mailing Address - Fax:734-455-0035
Practice Address - Street 1:990 W ANN ARBOR TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-6204
Practice Address - Country:US
Practice Address - Phone:734-455-4200
Practice Address - Fax:734-455-0035
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRU 040776207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108224181OtherBCBS INS.
103717OtherCARE CHOICES INSURANCE
MI1619494Medicaid
103717SPOtherSPECIALIST CARE CHOICES
103717SPOtherSPECIALIST CARE CHOICES
103717OtherCARE CHOICES INSURANCE