Provider Demographics
NPI:1780676189
Name:CHESLEY, JUDY STERNBERG (MD)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:STERNBERG
Last Name:CHESLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANN
Other - Last Name:STERNBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-9556
Mailing Address - Fax:605-328-9501
Practice Address - Street 1:1601 SIOUX VALLEY DR
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:MN
Practice Address - Zip Code:56156
Practice Address - Country:US
Practice Address - Phone:507-283-4476
Practice Address - Fax:507-283-9086
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN41424207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN256524200Medicaid
MN256524200Medicaid
MN080012303Medicare PIN
MNP00003483Medicare PIN
MN080010305Medicare PIN
MN080180829Medicare PIN