Healthcare Provider Details

I. General information

NPI: 1689824062
Provider Name (Legal Business Name): SHAWN G STERN DO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 JACOB ST SUITE 703
WHEELING WV
26003-3800
US

IV. Provider business mailing address

PO BOX 6482
WHEELING WV
26003-0811
US

V. Phone/Fax

Practice location:
  • Phone: 304-234-8409
  • Fax: 304-234-8804
Mailing address:
  • Phone: 304-233-2455
  • Fax: 304-233-6073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SHAWN G STERN
Title or Position: MEMBER
Credential: DO
Phone: 304-234-8409