Provider Demographics
NPI:1043298995
Name:STERN, ALLEN HOWARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:HOWARD
Last Name:STERN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1558 E TRINITY BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3609
Mailing Address - Country:US
Mailing Address - Phone:334-396-3338
Mailing Address - Fax:334-244-4184
Practice Address - Street 1:1558 E TRINITY BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3609
Practice Address - Country:US
Practice Address - Phone:334-396-3338
Practice Address - Fax:334-244-4184
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL32OtherSTATE LICENSE NUMBER
AL32OtherSTATE LICENSE NUMBER
ALT68904Medicare UPIN