Provider Demographics
NPI:1306857784
Name:STERN, HERBERT JOEL (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:JOEL
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 1:2320 THORNTON RD
Mailing Address - Street 2:UNIT A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4906
Mailing Address - Country:US
Mailing Address - Phone:512-799-6176
Mailing Address - Fax:
Practice Address - Street 1:142 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2922
Practice Address - Country:US
Practice Address - Phone:434-799-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN73522080P0202X
NC392212080P0202X
SC151642080P0202X
NMMD2010-02432080P0202X
VA01012468692080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7979737Medicaid
SCN39221Medicaid
NC79737OtherBCBS
NC2155524DMedicare PIN
E61238Medicare UPIN
SCE612388186Medicare PIN