MEDICARE: DR. MICHAEL H STEIN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2698/T2070	OH

General Provider Information

NPI Number	:	1043396724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL H STEIN O.D.

Provider Business Mailing Address
First Line	:	648 ULVERSTON DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-3889
Country	:	US
Telephone Number	:	614-855-4206
Fax Number	:	614-855-7441

Provider Business Practice Location Address
First Line	:	1500 POLARIS PKWY STE 1154
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43240-2129
Country	:	US
Telephone Number	:	614-846-9430
Fax Number	:	614-846-9462

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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