MEDICARE: STERLING EMERGENCY PHYSICIANS OF PALMETTO PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74782	OTHER	FL	BCBS GROUP
2	DC5226	OTHER	FL	RR MCR GROUP

General Provider Information

NPI Number	:	1700871761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STERLING EMERGENCY PHYSICIANS OF PALMETTO PA

Provider Business Mailing Address
First Line	:	PO BOX 534235
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30353-4235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 W 68TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33016-1801
Country	:	US
Telephone Number	:	305-823-5000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROLAND CLARK
Credential	:	MD
Telephone Number	:	866-266-9874

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	04/20/2008

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Directions to “STERLING EMERGENCY PHYSICIANS OF PALMETTO PA ” Practice Location

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