Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 35237 | MN |
NPI | 1154332401 |
---|---|
Provider Name | Mark A Urban |
First Address | St Louis Park, MN 55426-1728 |
Second Address | Edina, MN 55435-4534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 15/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
108122C689 | UCARE (01) | |
235302400 | (05) | MN |
32025100 | WISC MEDICAID (01) | |
55A81UR | BLUECROSS BLUESHIELD (01) | |
925053 | MEDICA (01) | |
969990638008 | PREFERREDONE (01) | |
E79876 | (02) | |
HP14598 | HEALTHPARTNERS (01) |