Provider Demographics
NPI:1962442038
Name:STEIN, STEVEN HOWARD (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:HOWARD
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 1:196 CONANTVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1610
Mailing Address - Country:US
Mailing Address - Phone:860-456-1813
Mailing Address - Fax:860-456-1629
Practice Address - Street 1:196 CONANTVILLE RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1610
Practice Address - Country:US
Practice Address - Phone:860-456-1813
Practice Address - Fax:860-456-1629
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT026104207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT10261049Medicaid
CTC59766Medicare UPIN