MEDICARE: DR. KENNETH HOWARD STERN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC-01866	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1679610687	OTHER	OH	NPI-GROUP
2	1063500460	OTHER	OH	NPI-INDIVIDUAL

General Provider Information

NPI Number	:	1063500460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH HOWARD STERN DC

Provider Business Mailing Address
First Line	:	13550 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-3434
Country	:	US
Telephone Number	:	216-476-1300
Fax Number	:	216-476-1950

Provider Business Practice Location Address
First Line	:	13550 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-3434
Country	:	US
Telephone Number	:	216-431-4700
Fax Number	:	216-671-5177

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	11/23/2024

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Directions to “ DR. KENNETH HOWARD STERN DC” Practice Location

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