Healthcare Provider Details

I. General information

NPI: 1942444047
Provider Name (Legal Business Name): SETH ADAM STEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 02/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MAIN ST
LEWISTON ME
04240-7027
US

IV. Provider business mailing address

300 MAIN ST
LEWISTON ME
04240-7027
US

V. Phone/Fax

Practice location:
  • Phone: 207-795-7575
  • Fax: 207-344-0350
Mailing address:
  • Phone: 207-795-0111
  • Fax: 207-795-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD20521
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD20521
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: