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NPI Code Detail

MEDICARE: MR. JOHN STEIN PA-C

MEDICARE: MR. JOHN STEIN PA-C
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
1363A00000XPhysician Assistant2011WV

General Provider Information

NPI Number : 1265980452
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN STEIN PA-C
Provider Business Mailing Address
First Line : 1005 WHITE WILLOW WAY
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-6119
Country : US
Telephone Number : 304-460-5123
Fax Number : 800-734-8498
Provider Business Practice Location Address
First Line : 1005 WHITE WILLOW WAY
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-6119
Country : US
Telephone Number : 304-460-5123
Fax Number : 800-734-8498
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2016
Last Update Date : 09/15/2016

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