Provider Demographics
NPI:1407837883
Name:STEIN, ROBERT D (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:D
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:85 CHURCH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457
Mailing Address - Country:US
Mailing Address - Phone:860-347-3304
Mailing Address - Fax:860-346-3517
Practice Address - Street 1:85 CHURCH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457
Practice Address - Country:US
Practice Address - Phone:860-347-3304
Practice Address - Fax:860-346-3517
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT019901207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1199017Medicaid
CTE34278Medicare UPIN
CT110001793Medicare ID - Type Unspecified