Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 036116388 | IL |
Y | 2084N0400X | Neurologist | 52554 | AZ |
NPI | 1003836081 |
---|---|
Provider Name | Dr. Michael A Stein |
First Address | Phoenix, AZ 85013-4407 |
Second Address | Phoenix, AZ 85013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 17/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
182299 | (05) | AZ |
336-077434 | STATE CONTOLLED SUBSTANCE (01) | IL |