Provider Demographics
NPI:1407854490
Name:KURBAN, RAMSAY S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMSAY
Middle Name:S
Last Name:KURBAN
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 1:845 NORMAN DR
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7445
Mailing Address - Country:US
Mailing Address - Phone:717-273-8091
Mailing Address - Fax:717-273-9081
Practice Address - Street 1:845 NORMAN DR
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7445
Practice Address - Country:US
Practice Address - Phone:717-273-8091
Practice Address - Fax:717-273-9081
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043706L174400000X, 207ZD0900X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1520324OtherGATEWAY INS PROVIDER #
PA671850HE5OtherMCB/P-TAN
PA02024202OtherCAP BC IND PROVIDER #
PA0012800250001Medicaid
PA671850OtherBS IND PROVIDER #
PAE24201Medicare UPIN