Provider Demographics
NPI:1760486278
Name:STERN, MILTON J (DPM)
Entity Type:Individual
Prefix:
First Name:MILTON
Middle Name:J
Last Name:STERN
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE L40
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3230
Mailing Address - Country:US
Mailing Address - Phone:248-851-4900
Mailing Address - Fax:248-851-4901
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:STE L40
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-851-4900
Practice Address - Fax:248-851-4901
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-13
Last Update Date:2010-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIMS000934213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT34292Medicare UPIN