Provider Demographics
NPI:1063405397
Name:STEIN, MARK H (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:STEIN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8330 NAAB RD
Mailing Address - Street 2:STE 307
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5925
Mailing Address - Country:US
Mailing Address - Phone:317-872-0400
Mailing Address - Fax:317-872-9577
Practice Address - Street 1:8330 NAAB RD
Practice Address - Street 2:STE 307
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5925
Practice Address - Country:US
Practice Address - Phone:317-872-0400
Practice Address - Fax:317-872-9577
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2019-03-19
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Provider Licenses
StateLicense IDTaxonomies
IN01025781208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100059920AMedicaid