Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 58648 | MA |
NPI | 1053309328 |
---|---|
Provider Name | Eric H Stein |
First Address | Chelmsford, MA 01824-2738 |
Second Address | Chelmsford, MA 01824-2738 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2005 |
Last Update Date | 31/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3103463 | (05) | MA |
F26441 | (02) | |
J12324 | BCBS (01) | MA |