Individual
GWEN A STEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 ANNANDALE BLVD, ANNANDALE, MN 55302
(651) 259-3850
Mailing address
400 E 1ST ST, MORRIS, MN 56267-1408
(320) 589-7625
(320) 589-7686
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
13887
AZ
2084P0800X
Psychiatry Physician
Primary
37744
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28T44HO
BCBS
—
05
—
358217500
—
MN
01
—
585241010541
PREFERRED ONE
—
Enumeration date
05/17/2006
Last updated
05/29/2018
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