Provider Demographics
NPI:1679662092
Name:STEIN, RONALD ALAN (DPM)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:ALAN
Last Name:STEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 CORPORATE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-4453
Mailing Address - Country:US
Mailing Address - Phone:330-655-5000
Mailing Address - Fax:330-342-9582
Practice Address - Street 1:1315 CORPORATE DR
Practice Address - Street 2:SUITE B
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-4453
Practice Address - Country:US
Practice Address - Phone:330-655-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002674213E00000X, 213EP1101X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0382134Medicaid
U41897Medicare UPIN
OH0382134Medicaid
OH5359380001Medicare NSC