MEDICARE: JONATHAN 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	207RC0000X	Cardiovascular Disease Physician

Other Identifiers

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

General Provider Information

NPI Number	:	1992751200
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN STEIN MD

Provider Business Mailing Address
First Line	:	104 SHINNECOCK HILLS DR
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-6175
Country	:	US
Telephone Number	:	337-856-1036
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 SHINNECOCK HILLS DR
Second Line	:
City	:	BROUSSARD
State	:	LA
Zip	:	70518-6175
Country	:	US
Telephone Number	:	337-856-1036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN H. STEIN
Credential	:	M.D.
Telephone Number	:	337-367-1936

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	02/03/2011

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