Provider Demographics
NPI:1467563494
Name:STEIN, MARK RODGER (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RODGER
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 1:840 US HIGHWAY 1
Mailing Address - Street 2:SUITE 235
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-3830
Mailing Address - Country:US
Mailing Address - Phone:561-626-2006
Mailing Address - Fax:561-624-9718
Practice Address - Street 1:840 US HIGHWAY 1
Practice Address - Street 2:SUITE 235
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-3830
Practice Address - Country:US
Practice Address - Phone:561-626-2006
Practice Address - Fax:561-624-9718
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0034195207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0555287OtherAETNA HMO PROVIDER NUMBER
06582OtherWELLCARE PROVIDER NUMBER
002927OtherNEIGHBORHOOD HEALTH PROV.
205911OtherAMERIGROUP PROVIDER NUMBE
206605OtherAVMED CHOICE PROVIDER NO.
8208118OtherAETNA PPO PROVIDER NUMBER
5157215OtherCCN PROVIDER NUMBER
716174OtherFIRST HEALTH PROVIDER NO
A04818OtherAMERIHEALTH
K25925OtherMEDVIEW
1251922001OtherCIGNA PROVIDER NUMBER
FL50917OtherBLUE CROSS PROVIDER NUMBE
P1572476OtherOXFORD HEALTH PROVIDER NO
1010747OtherCAREPLUS HMO PROVIDER NO.
002927OtherNEIGHBORHOOD HEALTH PROV.
P1572476OtherOXFORD HEALTH PROVIDER NO