Healthcare Provider Details

I. General information

NPI: 1982681995
Provider Name (Legal Business Name): JOHN ALAN STERN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 01/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PENNSYLVANIA AVE STE 525
DES MOINES IA
50316-2350
US

IV. Provider business mailing address

1301 PENNSYLVANIA AVE STE 525
DES MOINES IA
50316-2350
US

V. Phone/Fax

Practice location:
  • Phone: 515-422-2754
  • Fax: 515-864-0260
Mailing address:
  • Phone: 515-422-2754
  • Fax: 515-864-0260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD-26585
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number26585
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: