Provider Demographics
NPI:1235193236
Name:STERN, STEPHEN F (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:STERN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 MAPLE AVE E
Mailing Address - Street 2:SUITE 204
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4746
Mailing Address - Country:US
Mailing Address - Phone:703-281-4500
Mailing Address - Fax:703-242-8475
Practice Address - Street 1:527 MAPLE AVE E
Practice Address - Street 2:SUITE 204
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4746
Practice Address - Country:US
Practice Address - Phone:703-281-4500
Practice Address - Fax:703-242-8475
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000238213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA312945OtherMDIPA/OPTIMUM CHOICE
VI4092107OtherAETNA MC
VA7246OtherBLUE SHIELD OF DC
VA0587601OtherAETNA HMO
VA061712OtherBLUE SHIELD OF VA
VA27-00089OtherUNITEDHEALTHCARE
VA930043-1Medicaid
VAT31229Medicare UPIN
VAG01797Medicare PIN
VA27-00089OtherUNITEDHEALTHCARE