Healthcare Provider Details
I. General information
NPI: 1649205444
Provider Name (Legal Business Name): ROBERT B STERN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/11/2006
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
322 1/2 COLLEGE AVE
IOWA FALLS IA
50126-2106
US
IV. Provider business mailing address
322 1/2 COLLEGE AVE
IOWA FALLS IA
50126-2106
US
V. Phone/Fax
- Phone: 641-648-6491
- Fax: 641-648-7138
- Phone: 641-648-6491
- Fax: 641-648-7138
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 219276 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | 02401 |
| License Number State | IA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: