Provider Demographics
NPI:1518989839
Name:URBANSKI, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:URBANSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:110 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:EAST TAWAS
Mailing Address - State:MI
Mailing Address - Zip Code:48730-1328
Mailing Address - Country:US
Mailing Address - Phone:989-362-8681
Mailing Address - Fax:989-362-3321
Practice Address - Street 1:1683 LITTLESTONE RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1954
Practice Address - Country:US
Practice Address - Phone:313-885-6049
Practice Address - Fax:313-417-2473
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301050733207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1108209971OtherBCBSM
MIF10082Medicare UPIN
MI0P62510 001Medicare PIN