Healthcare Provider Details

I. General information

NPI: 1629016498
Provider Name (Legal Business Name): STEPHEN L STERN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

811 10TH AVE N
BESSEMER AL
35020-5320
US

IV. Provider business mailing address

PO BOX 829
COLUMBIANA AL
35051-0829
US

V. Phone/Fax

Practice location:
  • Phone: 205-424-9199
  • Fax: 205-424-9189
Mailing address:
  • Phone: 205-669-0999
  • Fax: 205-669-3348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number226
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: