Provider Demographics
NPI:1710915905
Name:POSTULA-STEIN, JASON EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:EDWARD
Last Name:POSTULA-STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:JASON
Other - Middle Name:EDWARD
Other - Last Name:POSTULA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9912 E GRAND RIVER AVE STE 1000
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-1973
Mailing Address - Country:US
Mailing Address - Phone:810-258-8442
Mailing Address - Fax:810-588-4353
Practice Address - Street 1:9912 E GRAND RIVER AVE
Practice Address - Street 2:#100
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116
Practice Address - Country:US
Practice Address - Phone:810-588-4214
Practice Address - Fax:810-588-4353
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301076568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4244327Medicaid
MICG4894OtherMEDICARE RAILROAD
MI0H24978OtherBLUE CROSS BLUE SHIELD
MIH25817Medicare UPIN
MI4244327Medicaid