Individual
DR. MARK ROBERT URBAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-1000
Mailing address
4195 N BODENHEIMER ST, BOISE, ID 83703-4201
(208) 629-2146
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
80808
AZ
208000000X
Pediatrics Physician
80808
AZ
Other
Enumeration date
01/28/2008
Last updated
03/09/2021
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