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General NPI Number Information
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NPI Number | 1760640718
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Entity Type | Organization
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Legal Business Name | BENJAMIN H STEIN OD INC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 07/14/2010
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Provider Practice Location Address
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Address Line | 21500 NORTHWESTERN HWY SUITE #635
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5018
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Country | US
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Telephone | 248-569-2025
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Fax | 248-569-5103
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Provider Business Mailing Address
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Address Line | 21500 NORTHWESTERN HWY SUITE #635
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5018
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Country | US
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Telephone | 248-569-2025
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Fax | 248-569-5103
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Authorized Official
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Title or Position | PRESIDENT/SEC. TREAS.
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Name | MR. STUART ALAN STEIN
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Credential |
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Telephone | 248-569-2025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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