MEDICARE: SUSAN R. STEIN MD

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
1	207V00000X	Obstetrics & Gynecology Physician	34974	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	ZFQ31815	OTHER	MEDICARE
2	031881	OTHER	MEDICARE
3	031815	OTHER	MEDICARE
5	Z92977	OTHER	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629007703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN R. STEIN MD

Provider Business Mailing Address
First Line	:	PO BOX 10097
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85130-0020
Country	:	US
Telephone Number	:	520-381-0380
Fax Number	:	520-836-1826

Provider Business Practice Location Address
First Line	:	580 N CAMINO MERCADO STE 8
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-5757
Country	:	US
Telephone Number	:	520-381-0380
Fax Number	:	520-836-1826

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	12/02/2021

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Directions to “ SUSAN R. STEIN MD” Practice Location

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