Provider Demographics
NPI:1831114883
Name:STEIN, ANOUK (MD)
Entity Type:Individual
Prefix:
First Name:ANOUK
Middle Name:
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 E GLENHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-0527
Mailing Address - Country:US
Mailing Address - Phone:480-993-8176
Mailing Address - Fax:
Practice Address - Street 1:4127 E GLENHAVEN DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0527
Practice Address - Country:US
Practice Address - Phone:480-993-8176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ318752085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01425158Medicaid
NY67H021Medicare ID - Type Unspecified
NY01425158Medicaid