Provider Demographics
NPI:1063465938
Name:STEIN, EDWARD P (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:P
Last Name:STEIN
Suffix:
Gender:
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:PO BOX 2069
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MT
Mailing Address - Zip Code:59917-2069
Mailing Address - Country:US
Mailing Address - Phone:406-297-3145
Mailing Address - Fax:406-297-3364
Practice Address - Street 1:304 OSLOSKI RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9217
Practice Address - Country:US
Practice Address - Phone:406-297-3145
Practice Address - Fax:406-297-3364
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1063465938OtherBCBS
MT1063465938Medicaid
000085270Medicare PIN