Provider Demographics
NPI:1962442558
Name:URBANO, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:URBANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 REECEVILLE RD
Mailing Address - Street 2:SUITE 32
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320
Mailing Address - Country:US
Mailing Address - Phone:610-384-1600
Mailing Address - Fax:610-384-8555
Practice Address - Street 1:213 REECEVILLE RD
Practice Address - Street 2:SUITE 32
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-384-1600
Practice Address - Fax:610-384-8555
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058342L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA457081OtherAETNA
PA30010029OtherKEYSTONE MERCY
PA0016134540006Medicaid
PA0206159000OtherKEYSTONE
PA0438001OtherUNITED HEALTHCARE
PA0161345401OtherAMERICHOICE
PA0206159000OtherINDEPENDENCE BLUE CROSS
PA331517OtherCOVENTRY HEALTH CARE/FIRST HEALTH NETWORK
PA457081OtherAETNA
PA0206159000OtherKEYSTONE