Provider Demographics
NPI:1679671416
Name:STEIN, STEVEN E (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
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 1:1579 W BIG BEAVER RD
Mailing Address - Street 2:SUITE B-7
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084
Mailing Address - Country:US
Mailing Address - Phone:248-643-7710
Mailing Address - Fax:248-643-7731
Practice Address - Street 1:1579 W BIG BEAVER RD
Practice Address - Street 2:SUITE B-7
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084
Practice Address - Country:US
Practice Address - Phone:248-643-7710
Practice Address - Fax:248-643-7731
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISS407211208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4602598OtherPPOM
MI2960947Medicaid
F18305Medicare UPIN
MI0633057Medicare ID - Type Unspecified