Provider Demographics
NPI:1538115878
Name:STERN, ALAN KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:KEVIN
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 1:86 MEETINGHOUSE CIR
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-1858
Mailing Address - Country:US
Mailing Address - Phone:781-444-7626
Mailing Address - Fax:
Practice Address - Street 1:111 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2900
Practice Address - Country:US
Practice Address - Phone:781-444-7186
Practice Address - Fax:781-449-4617
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA79923174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2802230OtherAETNA
MA079923OtherTUFTS
MA200485OtherHPHC
MA1201292OtherUNITED
MA3143422Medicaid
MAJ14695OtherBCBS
MA3143422Medicaid