Provider Demographics
NPI:1417168352
Name:NAWAB, URSULA S (MD)
Entity Type:Individual
Prefix:DR
First Name:URSULA
Middle Name:S
Last Name:NAWAB
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9258
Mailing Address - Fax:267-425-9299
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:THE CHILDREN'S HOSPITAL OF PHILA - NEONATOLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1944
Practice Address - Fax:215-590-4454
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2015-04-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA079476002080N0001X
TX420572080N0001X
TXN22082080N0001X
PAMD4194222080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190088801Medicaid
TX8AL073OtherBCBS
I37543Medicare UPIN
TX8AL073OtherBCBS