Healthcare Provider Details

I. General information

NPI: 1437151388
Provider Name (Legal Business Name): LARRY A STERN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 CLEVELAND RD STE 102
WOOSTER OH
44691-2335
US

IV. Provider business mailing address

3540 BURBANK RD # 127
WOOSTER OH
44691-8539
US

V. Phone/Fax

Practice location:
  • Phone: 330-263-8750
  • Fax: 330-263-8752
Mailing address:
  • Phone: 330-465-4429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35054753S
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number35054753S
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: