Provider Demographics
NPI:1932146628
Name:URBAN, WILLIAM CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CHRISTOPHER
Last Name:URBAN
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 1:1300 RITCHIE HIGHWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-544-6038
Mailing Address - Fax:410-349-9940
Practice Address - Street 1:1600 S CRAIN HIGHWAY
Practice Address - Street 2:SUITE 401
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061
Practice Address - Country:US
Practice Address - Phone:410-768-5050
Practice Address - Fax:410-768-7830
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0061076207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H86261Medicare UPIN
MDI873Medicare ID - Type Unspecified