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Individual

DONALD A URBAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11141 PARKVIEW PLAZA DR STE 320, FORT WAYNE, IN 46845-1714
(260) 482-8681
(260) 969-0350
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01063766A
IN
208800000X
Urology Physician
16424
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000633892
ANCATHEM
IN
05
000084519
AL
01
00573328
MISSISSIPPI MEDICAID
AL
05
200862950
IN
01
P00103932
RAILROAD MEDICARE
AL
01
P00811409
MEDICARE RAILROAD
IN
Enumeration date
07/24/2006
Last updated
11/15/2022
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