Provider Demographics
NPI:1194810911
Name:URBAN, MARK D (PA-C)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:URBAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:US CENTERS FOR DISEASE CONTROL
Mailing Address - Street 2:4024 STIRRUP CREEK DR
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703
Mailing Address - Country:US
Mailing Address - Phone:919-541-0562
Mailing Address - Fax:
Practice Address - Street 1:US CENTERS FOR DISEASE CONTROL
Practice Address - Street 2:4024 STIRRUP CREEK DR
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703
Practice Address - Country:US
Practice Address - Phone:919-541-0562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
146L00000X, 171000000X, 1710I1002X, 1710I1003X, 2472B0301X
NY5410562363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No171000000XOther Service ProvidersMilitary Health Care Provider
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
No1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
No2472B0301XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherBiomedical Engineering
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5410562OtherIDC-PA