Provider Demographics
NPI:1427175512
Name:URWILLER, RICHARD DEAN (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:URWILLER
Suffix:
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 1:16136 W GALLERIA LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374
Mailing Address - Country:US
Mailing Address - Phone:623-546-0805
Mailing Address - Fax:
Practice Address - Street 1:16136 W GALLERIA LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:623-546-0805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO14087INACTIVE208800000X
NE9996ACTIVE208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AU0811201OtherDEA