Provider Demographics
NPI:1568663110
Name:KURBAN, HENRY M (MD, MBA, MPH)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:M
Last Name:KURBAN
Suffix:
Gender:M
Credentials:MD, MBA, MPH
Other - Prefix:
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Mailing Address - Street 1:1 ATWELL RD
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-1301
Mailing Address - Country:US
Mailing Address - Phone:607-547-3276
Mailing Address - Fax:607-547-3259
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3276
Practice Address - Fax:607-547-3259
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1085772083P0901X, 208D00000X
MDD00683422083P0901X, 208D00000X
VA01012504292083P0901X, 208D00000X
NY2819282083P0901X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine