Individual
BRUCE A URBAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 LEE ST, CHARLOTTESVILLE, VA 22908-4400
(434) 924-9400
(434) 982-1618
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(342) 951-0000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
0101226377
VA
2085N0904X
Nuclear Radiology Physician
0101226377
VA
2085P0229X
Pediatric Radiology Physician
0101226377
VA
2085R0202X
Diagnostic Radiology Physician
Primary
0101226377
VA
2085R0204X
Vascular & Interventional Radiology Physician
0101226377
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0053
CAREFIRST BCBS
VA
05
—
0120967000
—
WV
Enumeration date
07/11/2006
Last updated
01/23/2024
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