MEDICARE: BARRY 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	208800000X	Urology Physician	5046	AZ

General Provider Information

NPI Number	:	1609865310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY STERN MD

Provider Business Mailing Address
First Line	:	8765 W KELTON LN
Second Line	:	STE B1-110
City	:	PEORIA
State	:	AZ
Zip	:	85382-3584
Country	:	US
Telephone Number	:	623-974-3621
Fax Number	:	623-974-3622

Provider Business Practice Location Address
First Line	:	14300 W GRANITE VALLEY DR
Second Line	:	STE B6
City	:	SUN CITY
State	:	AZ
Zip	:	85375-5783
Country	:	US
Telephone Number	:	623-974-3621
Fax Number	:	623-974-3622

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	05/10/2017

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