Provider Demographics
NPI:1609945542
Name:WILLIAM M URBAS DPM PC
Entity Type:Organization
Organization Name:WILLIAM M URBAS DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:URBAS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-534-6330
Mailing Address - Street 1:1501 LANSDOWNE AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-1333
Mailing Address - Country:US
Mailing Address - Phone:610-534-6330
Mailing Address - Fax:610-534-6339
Practice Address - Street 1:1501 LANSDOWNE AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-1333
Practice Address - Country:US
Practice Address - Phone:610-534-6330
Practice Address - Fax:610-534-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002791L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01287625Medicaid
PA01287625Medicaid
T77859Medicare UPIN
PA123548Medicare ID - Type UnspecifiedGROUP