Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | MD421701 | PA |
NPI | 1033369533 |
---|---|
Provider Name | Peter Gore Stein |
First Address | Crum Lynne, PA 19022-1022 |
Second Address | Crum Lynne, PA 19022-1022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2008 |
Last Update Date | 24/09/2011 |