Provider Demographics
NPI:1790757821
Name:STEIN, IRA E (M D)
Entity Type:Individual
Prefix:
First Name:IRA
Middle Name:E
Last Name:STEIN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 23RD AVE N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1534
Mailing Address - Country:US
Mailing Address - Phone:615-342-5900
Mailing Address - Fax:615-342-7898
Practice Address - Street 1:330 23RD AVE N
Practice Address - Street 2:SUITE 300
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1534
Practice Address - Country:US
Practice Address - Phone:615-342-5900
Practice Address - Fax:615-342-7898
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000022169207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3090269Medicaid
TNG00855Medicare UPIN
TN3090269Medicare ID - Type Unspecified