Healthcare Provider Details

I. General information

NPI: 1912914870
Provider Name (Legal Business Name): JOHN MICHAEL STEIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 E 2ND ST STE 310
SCOTTSDALE AZ
85251-5627
US

IV. Provider business mailing address

9502 N 46TH ST
PHOENIX AZ
85028-5201
US

V. Phone/Fax

Practice location:
  • Phone: 480-970-1640
  • Fax: 480-970-1641
Mailing address:
  • Phone: 623-977-5466
  • Fax: 623-875-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number11573
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: