Provider Demographics
NPI:1700855137
Name:STERLING, CONNIE JO (MD)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:JO
Last Name:STERLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4950 E. ELLIOT RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-4306
Mailing Address - Country:US
Mailing Address - Phone:480-893-2900
Mailing Address - Fax:480-893-2911
Practice Address - Street 1:4950 E ELLIOT RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4306
Practice Address - Country:US
Practice Address - Phone:480-893-2900
Practice Address - Fax:480-893-2911
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ08ZWCHZN02Medicare PIN
AZE85958Medicare UPIN