Provider Demographics
NPI:1144494931
Name:STEIN, ELISA A (MD)
Entity type:Individual
Prefix:DR
First Name:ELISA
Middle Name:A
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7008
Mailing Address - Country:US
Mailing Address - Phone:336-802-2150
Mailing Address - Fax:336-802-2151
Practice Address - Street 1:1814 WESTCHESTER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7299
Practice Address - Country:US
Practice Address - Phone:336-802-2150
Practice Address - Fax:336-802-2151
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2011 01308208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5920489Medicaid
NCNC7080AMedicare PIN