Healthcare Provider Details

I. General information

NPI: 1336226729
Provider Name (Legal Business Name): STERLING MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 OAK ST
CINCINNATI OH
45219-2598
US

IV. Provider business mailing address

125 E 5TH AVE
NORTH POLE AK
99705-7774
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-1800
  • Fax: 513-984-4909
Mailing address:
  • Phone: 907-488-2839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1100X
TaxonomyMilitary/U.S. Coast Guard Outpatient Clinic/Center
License Number5650
License Number StateAK

VIII. Authorized Official

Name: MS. LAURA MOORE
Title or Position: CREDENTIALS COORDINATOR
Credential:
Phone: 513-984-1800