Provider Demographics
NPI:1013017581
Name:STIEN, ERIK MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:MICHAEL
Last Name:STIEN
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 1:5 ALUMNI DR
Mailing Address - Street 2:
Mailing Address - City:EXETER
Mailing Address - State:NH
Mailing Address - Zip Code:03833-2128
Mailing Address - Country:US
Mailing Address - Phone:603-778-1311
Mailing Address - Fax:
Practice Address - Street 1:5 ALUMNI DR
Practice Address - Street 2:
Practice Address - City:EXETER
Practice Address - State:NH
Practice Address - Zip Code:03833
Practice Address - Country:US
Practice Address - Phone:603-778-7311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH169252085R0202X
CT0456312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3108769Medicaid
CT010045631CT04OtherANTHEM BC/BS
CT001456319Medicaid
CT010045631CT03OtherANTHEM BC/BS
CT010045631CT10OtherANTHEM BC/BS
CT010045631CT08OtherANTHEM BC/BS
CT010045631CT09OtherANTHEM BC/BS
CT300004070Medicare PIN
CT010045631CT04OtherANTHEM BC/BS
CT001456319Medicaid
CT300004074Medicare PIN
CT300004072Medicare PIN
CT300004071Medicare PIN
CT010045631CT10OtherANTHEM BC/BS