Gwen A Stein, MD
Individual provider Active NPI Psychiatry Physician · Annandale, MN
NPI 1801848635 · NPPES record last updated May 29, 2018
Key facts
- NPI
- 1801848635
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 37744 (MN)
- Practice address
- 400 Annandale Blvd
Annandale, MN 55302 - Phone
- (651) 259-3850
- NPI assigned
- May 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13887 | AZ | MD | Psychiatry Physician |
| 37744 | MN | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Behavioral Health Hospital Alexandria | Past |
Accepting new patients | |
| Community Behavioral Health Hospital Annandale | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 13887 | AZ | |
| Psychiatry Physician | 2084P0800X | 37744 | MN | Yes |
Addresses
Primary practice location
400 Annandale Blvd
Annandale, MN 55302
Mailing address
400 E 1St St
Morris, MN 56267-1408
Phone (320) 589-7625
Other practice location 1
400 E 1st St
Morris, MN 56267-1408
Phone (320) 589-7625
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28T44HO | Other | BCBS | |
| 585241010541 | Other | PREFERRED ONE | |
| 358217500 | Medicaid | MN |
Other providers in Annandale, MN
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- Ashley Semann
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- Shannon Shun
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- Nicholas Gene Stephens
- Jonathan Strohschein
- Katie Nicole Tancabel
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All providers in Annandale, MN · Psychiatry Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.