Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 034577 | CT |
N | 111NI0900X | Internist | 034577 | CT |
N | 2080P0210X | Pediatric Nephrologist | 034577 | CT |
Y | 2080P0210X | Pediatric Nephrologist | 2016029301 | MO |
NPI | 1952583809 |
---|---|
Provider Name | Jeffrey Mark Stein |
First Address | Kansas City, MO 64184-3966 |
Second Address | Columbia, MO 65201-6626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2007 |
Last Update Date | 09/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001345778 | (05) | CT |
G11030 | (02) |