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NPI Code Detail

MEDICARE: KIM M. STEIN M.D.

MEDICARE: KIM M. STEIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine Physician0101260470VA

General Provider Information

NPI Number : 1396188710
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM M. STEIN M.D.
Provider Business Mailing Address
First Line : PO BOX 9007
Second Line :
City : CHARLOTTESVILLE
State : VA
Zip : 22906-9007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4916 PLANK RD UNIT 205
Second Line :
City : NORTH GARDEN
State : VA
Zip : 22959-1613
Country : US
Telephone Number : 434-243-4660
Fax Number : 434-977-3703
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2013
Last Update Date : 08/11/2016

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