Provider Demographics
NPI:1649205444
Name:STERN, ROBERT B (DO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:B
Last Name:STERN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 1/2 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:IOWA FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50126-2106
Mailing Address - Country:US
Mailing Address - Phone:641-648-6491
Mailing Address - Fax:641-648-7138
Practice Address - Street 1:322 1/2 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:IOWA FALLS
Practice Address - State:IA
Practice Address - Zip Code:50126-2106
Practice Address - Country:US
Practice Address - Phone:641-648-6491
Practice Address - Fax:641-648-7138
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2192762084P0800X
IA024012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
F57936Medicare UPIN
IAF57936Medicare UPIN
IAI12755Medicare ID - Type Unspecified