Healthcare Provider Details

I. General information

NPI: 1801882311
Provider Name (Legal Business Name): PETER J STERN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

538 OAK ST SUITE 200
CINCINNATI OH
45219-2507
US

IV. Provider business mailing address

4685 FOREST AVE STE C
CINCINNATI OH
45212-3359
US

V. Phone/Fax

Practice location:
  • Phone: 513-961-4263
  • Fax: 513-961-1503
Mailing address:
  • Phone: 513-853-4731
  • Fax: 513-569-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number35042929
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35.042929
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: