Provider Demographics
NPI:1770706087
Name:DR ROBERT M STEIN PC
Entity type:Organization
Organization Name:DR ROBERT M STEIN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:313-871-6103
Mailing Address - Street 1:8713 JOSEPH CAMPAU ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-3720
Mailing Address - Country:US
Mailing Address - Phone:313-871-6103
Mailing Address - Fax:313-871-3957
Practice Address - Street 1:8713 JOSEPH CAMPAU ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-3720
Practice Address - Country:US
Practice Address - Phone:313-871-6103
Practice Address - Fax:313-871-3957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS000693213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1185732Medicaid
MI=========OtherTAX ID NUMBER
T34370Medicare UPIN
4417980001Medicare NSC
MI1185732Medicaid