Provider Demographics
NPI:1073626024
Name:STEIN, DREW A (MD)
Entity Type:Individual
Prefix:DR
First Name:DREW
Middle Name:A
Last Name:STEIN
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 1:6853 SW18TH STREET
Mailing Address - Street 2:SUITE M111
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7056
Mailing Address - Country:US
Mailing Address - Phone:561-617-7996
Mailing Address - Fax:
Practice Address - Street 1:6853 SW18TH STREET
Practice Address - Street 2:SUITE M111
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7056
Practice Address - Country:US
Practice Address - Phone:561-617-7996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY203559207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3215698OtherAETNA HMO
NY562361830OtherHORIZON
NY784650OtherAETNA NON-HMO
NY02442088Medicaid
NY562361830OtherPHCS
NY502547OtherGHI
NY523G52OtherBCBS
NYP2679844OtherOXFORD
NY502547OtherGHI
NYH60475Medicare UPIN