Provider Demographics
NPI:1902828825
Name:STEIN, DARRYL G (MD)
Entity Type:Individual
Prefix:MR
First Name:DARRYL
Middle Name:G
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7779
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AL
Mailing Address - Zip Code:85011
Mailing Address - Country:US
Mailing Address - Phone:480-248-3000
Mailing Address - Fax:480-248-3050
Practice Address - Street 1:1830 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 108
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3056
Practice Address - Country:US
Practice Address - Phone:480-248-3000
Practice Address - Fax:480-248-3050
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ25394208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ385113Medicaid
G47510Medicare UPIN
AZ385113Medicaid