Provider Demographics
NPI:1003890120
Name:STEIN, MITCHELL E (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:E
Last Name:STEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E CITY AVE
Mailing Address - Street 2:2 BALA PLAZA
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1501
Mailing Address - Country:US
Mailing Address - Phone:610-668-1192
Mailing Address - Fax:610-668-1509
Practice Address - Street 1:333 E CITY AVE
Practice Address - Street 2:2 BALA PLAZA
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1501
Practice Address - Country:US
Practice Address - Phone:610-668-2777
Practice Address - Fax:610-668-1509
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051488L174400000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA180022095OtherMEDICARE ID TYPE UNSPECIFIED
PA501249OtherPA BLUE SHIELD
PA512352OtherAETNA HMO
PAA2279OtherMEDICARE ID TYPE UNSPECIFIED
PA0005377005OtherAETNA PPO
NJ2227390OtherUNITED HEALTHCARE
PA0053224000OtherKEYSTONE HEALTH PLAN
NJ045799OtherPA BLUE SHIELD
PA1029889OtherKEYSTONE MERCY HP
NJ569045OtherAETNA HMO
PA0015305200001Medicaid
NJ0132145000OtherAMERIHEALTH HMO
NJ0706610000OtherKEYSTONE HEALTH PLAN
PA10240MD051488LOtherHEALTH PARTNERS
NJ7064403Medicaid
NJ0132145000OtherKEYSTONE HEALTH PLAN
PA0683538000OtherKEYSTONE HEALTH PLAN
PA7900866OtherCIGNA HEALTH PLAN
NJ2227390OtherUNITED HEALTHCARE
PA1029889OtherKEYSTONE MERCY HP
NJ045799DCQMedicare PIN