Healthcare Provider Details

I. General information

NPI: 1356628473
Provider Name (Legal Business Name): ROBIN E STEIN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN E KOVATCH PA-C

II. Dates (important events)

Enumeration Date: 11/03/2011
Last Update Date: 11/27/2023
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7120 CLEARVISTA DR STE 2000
INDIANAPOLIS IN
46256-1621
US

IV. Provider business mailing address

6626 E 75TH ST STE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-7120
  • Fax: 317-621-7119
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA1665
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberTC051
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10001361A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: