Healthcare Provider Details

I. General information

NPI: 1730160458
Provider Name (Legal Business Name): JEREMY STERN MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 06/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300C FAUNCE CORNER RD
N DARTMOUTH MA
02747-1257
US

IV. Provider business mailing address

300C FAUNCE CORNER RD
N DARTMOUTH MA
02747-1257
US

V. Phone/Fax

Practice location:
  • Phone: 508-998-6100
  • Fax: 508-998-1411
Mailing address:
  • Phone: 508-998-6100
  • Fax: 508-998-1411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number76678
License Number StateMA

VIII. Authorized Official

Name: DR. JEREMY BEN STERN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 508-998-6100