Healthcare Provider Details

I. General information

NPI: 1720551153
Provider Name (Legal Business Name): WILLIAM STERN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 BALTIMORE PIKE
SPRINGFIELD PA
19064-3810
US

IV. Provider business mailing address

1470 LIMEPORT PIKE
COOPERSBURG PA
18036-3004
US

V. Phone/Fax

Practice location:
  • Phone: 484-470-2600
  • Fax:
Mailing address:
  • Phone: 484-553-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA060431
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: