Provider Demographics
NPI:1811044985
Name:STEIN, CARL (MD)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:
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 1:383 CENTRAL AVE
Mailing Address - Street 2:SUITE 232
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-6420
Mailing Address - Country:US
Mailing Address - Phone:603-749-0043
Mailing Address - Fax:603-749-0135
Practice Address - Street 1:383 CENTRAL AVE
Practice Address - Street 2:SUITE 323
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6420
Practice Address - Country:US
Practice Address - Phone:603-749-0043
Practice Address - Fax:603-749-0135
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13692207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30207052Medicaid
NH000320901Medicare PIN
NH30207052Medicaid