Healthcare Provider Details

I. General information

NPI: 1487688420
Provider Name (Legal Business Name): CRAIG STERNBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87B OMEGA DR
NEWARK DE
19713-2065
US

IV. Provider business mailing address

2600 GLASGOW AVE SUITE 105
NEWARK DE
19702-4773
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-0980
  • Fax: 302-733-7495
Mailing address:
  • Phone: 302-832-3369
  • Fax: 302-832-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberC10002806
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: