Provider Demographics
NPI:1134287360
Name:STEIN, MERYL P (DPM)
Entity Type:Individual
Prefix:
First Name:MERYL
Middle Name:P
Last Name:STEIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:MERYL
Other - Middle Name:P
Other - Last Name:LEVENSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-364-7000
Mailing Address - Fax:
Practice Address - Street 1:200 CRESCENT CENTRE PARK
Practice Address - Street 2:DEPARTMENT OF PODIATRY
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084
Practice Address - Country:US
Practice Address - Phone:770-496-3505
Practice Address - Fax:770-496-3442
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2022-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000606213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
48SCCQDMedicare ID - Type Unspecified
U08688Medicare UPIN