MEDICARE: MARK STERN MD

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	207RC0000X	Cardiovascular Disease Physician	11364	AZ
2	207RI0011X	Interventional Cardiology Physician	11364	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060028121	OTHER	AZ	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437127495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK STERN MD

Provider Business Mailing Address
First Line	:	6402 E SUPERSTITION SPRINGS BLVD STE 224
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85206-4394
Country	:	US
Telephone Number	:	480-835-6100
Fax Number	:	480-461-4261

Provider Business Practice Location Address
First Line	:	6750 E BAYWOOD AVE
Second Line	:	301
City	:	MESA
State	:	AZ
Zip	:	85206-1749
Country	:	US
Telephone Number	:	480-835-6100
Fax Number	:	480-461-4261

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

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	06/08/2016

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Directions to “ MARK STERN MD” Practice Location

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