Provider Demographics
NPI:1346554714
Name:STERN CARDIOLOGY PC
Entity Type:Organization
Organization Name:STERN CARDIOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:STERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:980-355-1959
Mailing Address - Street 1:4324 QUAIL VIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-7960
Mailing Address - Country:US
Mailing Address - Phone:980-355-1959
Mailing Address - Fax:704-543-0018
Practice Address - Street 1:196 CARDIOLOGY DRIVE
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-1174
Practice Address - Country:US
Practice Address - Phone:803-324-5135
Practice Address - Fax:803-324-8161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC151642080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7979737Medicaid
SCN39221Medicaid
SCE612388186Medicare PIN
E61238Medicare UPIN
SCN39221Medicaid