Provider Demographics
NPI:1043396724
Name:STEIN, MICHAEL H (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:STEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:648 ULVERSTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3889
Mailing Address - Country:US
Mailing Address - Phone:614-855-4206
Mailing Address - Fax:614-855-7441
Practice Address - Street 1:1500 POLARIS PKWY STE 1154
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-2129
Practice Address - Country:US
Practice Address - Phone:614-846-9430
Practice Address - Fax:614-846-9462
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2698/T2070152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist