Provider Demographics
NPI:1609898816
Name:URBANIK, EDWARD F JR (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:F
Last Name:URBANIK
Suffix:JR
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 1:9631 E MOUNTAIN SPRING RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6639
Mailing Address - Country:US
Mailing Address - Phone:480-419-6804
Mailing Address - Fax:
Practice Address - Street 1:9631 E MOUNTAIN SPRING RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-6639
Practice Address - Country:US
Practice Address - Phone:480-419-6804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ244852085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ426149Medicaid
AZ426149Medicaid