Healthcare Provider Details

I. General information

NPI: 1821450826
Provider Name (Legal Business Name): JOSEPH CLARK STERNER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2016
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 SMITH AVE N
SAINT PAUL MN
55102-2424
US

IV. Provider business mailing address

280 SMITH AVE N
SAINT PAUL MN
55102-2424
US

V. Phone/Fax

Practice location:
  • Phone: 651-241-8628
  • Fax:
Mailing address:
  • Phone: 651-241-8628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number66242
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: