Provider Demographics
NPI:1417048786
Name:STERN, HARVEY JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:JAY
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:GIVF PAYMENT/CORRESPONDENCE ADDRESS
Mailing Address - Street 2:PO BOX 17016
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1016
Mailing Address - Country:US
Mailing Address - Phone:703-289-1977
Mailing Address - Fax:703-698-3977
Practice Address - Street 1:GIVF
Practice Address - Street 2:3015 WILLIAMS DR. #300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:703-289-1977
Practice Address - Fax:703-697-3977
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044238207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCE72247Medicare UPIN