Provider Demographics
NPI:1639602360
Name:URBAN, STANLEY JOSEPH III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JOSEPH
Last Name:URBAN
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-5610
Mailing Address - Country:US
Mailing Address - Phone:586-468-0597
Mailing Address - Fax:
Practice Address - Street 1:35 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-5610
Practice Address - Country:US
Practice Address - Phone:586-468-0597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041401183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist