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General NPI Number Information
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NPI Number | 1245405240
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Entity Type | Individual
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Provider Name | AUGUSTUS GRAHAM STERN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2008
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 220 CHAMPION DR SUITE 100
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6558
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Country | US
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Telephone | 301-791-0888
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Fax | 301-791-3611
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Provider Business Mailing Address
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Address Line | 220 CHAMPION DR STE 100
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City | HAGERSTOWN
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State | MD
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Zip | 21740-6665
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Country | US
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Telephone | 301-791-0888
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Fax | 301-791-3611
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 200223
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | N4128
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D74254
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License Number State | MD
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