Provider Demographics
NPI:1417944414
Name:STERNBERG, BARRY MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:MARK
Last Name:STERNBERG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4386 KNIGHTSBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1625
Mailing Address - Country:US
Mailing Address - Phone:248-722-9252
Mailing Address - Fax:
Practice Address - Street 1:8282 WOODWARD AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2532
Practice Address - Country:US
Practice Address - Phone:313-875-9010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021273183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist