Provider Demographics
NPI:1124040365
Name:STERN, GREGORY H (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:H
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 GIRARD ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4005
Mailing Address - Country:US
Mailing Address - Phone:360-778-6000
Mailing Address - Fax:360-778-6001
Practice Address - Street 1:509 GIRARD ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4005
Practice Address - Country:US
Practice Address - Phone:360-778-6000
Practice Address - Fax:360-778-6101
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027449207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8291924Medicaid
WAAB25872Medicare ID - Type Unspecified
WAA53231Medicare UPIN