Healthcare Provider Details

I. General information

NPI: 1679671416
Provider Name (Legal Business Name): STEVEN E STEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 05/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 W BIG BEAVER RD SUITE B-7
TROY MI
48084
US

IV. Provider business mailing address

1579 W BIG BEAVER RD SUITE B-7
TROY MI
48084
US

V. Phone/Fax

Practice location:
  • Phone: 248-643-7710
  • Fax: 248-643-7731
Mailing address:
  • Phone: 248-643-7710
  • Fax: 248-643-7731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberSS407211
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: