Healthcare Provider Details

I. General information

NPI: 1811417900
Provider Name (Legal Business Name): ERIKA STEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 11/29/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 N PARK ST
NORTHWOOD ND
58267-4102
US

IV. Provider business mailing address

PO BOX 190
NORTHWOOD ND
58267-0190
US

V. Phone/Fax

Practice location:
  • Phone: 701-587-6060
  • Fax: 701-780-6817
Mailing address:
  • Phone: 701-587-6060
  • Fax: 701-780-6817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberRL14692
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16920
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: