MEDICARE: STEIN AVIATION MEDICINE LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1831122498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEIN AVIATION MEDICINE LLC

Provider Business Mailing Address
First Line	:	200 NORTHLAND BLVD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3604
Country	:	US
Telephone Number	:	513-672-4128
Fax Number	:	513-672-3323

Provider Business Practice Location Address
First Line	:	3020 BURNET AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2420
Country	:	US
Telephone Number	:	513-672-4128
Fax Number	:	513-672-3323

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROBERT STEIN
Credential	:	MD
Telephone Number	:	513-672-4128

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/22/2020

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