Provider Demographics
NPI:1275649212
Name:STEIN, BRIAN K (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:K
Last Name:STEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:BRIAN
Other - Middle Name:K
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DOF
Mailing Address - Street 1:3790 MORRELL AVENIUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114
Mailing Address - Country:US
Mailing Address - Phone:215-637-6901
Mailing Address - Fax:215-637-3229
Practice Address - Street 1:3790 MORRELL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1955
Practice Address - Country:US
Practice Address - Phone:215-637-6901
Practice Address - Fax:215-637-3229
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009661L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine