Provider Demographics
NPI:1811170673
Name:MARVIN L. STEIN, M.D. P.A.
Entity type:Organization
Organization Name:MARVIN L. STEIN, M.D. P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:954-979-2444
Mailing Address - Street 1:5800 COLONIAL DRIVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063
Mailing Address - Country:US
Mailing Address - Phone:954-979-2444
Mailing Address - Fax:954-979-2263
Practice Address - Street 1:5800 COLONIAL DR
Practice Address - Street 2:SUITE 404
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5682
Practice Address - Country:US
Practice Address - Phone:954-979-2444
Practice Address - Fax:954-979-2263
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARVIN L STEIN M.D.P.A
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-14
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD64606Medicare UPIN