Healthcare Provider Details

I. General information

NPI: 1679528954
Provider Name (Legal Business Name): DRS. STERN AND GANTT,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15001 SHADY GROVE RD SUITE 110
ROCKVILLE MD
20850-6352
US

IV. Provider business mailing address

15001 SHADY GROVE RD SUITE 110
ROCKVILLE MD
20850-6352
US

V. Phone/Fax

Practice location:
  • Phone: 301-251-9555
  • Fax: 301-309-0765
Mailing address:
  • Phone: 301-251-9555
  • Fax: 301-309-0765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0022865
License Number StateMD

VIII. Authorized Official

Name: DR. WILLIAM ROBERT STERN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 301-251-9555