Provider Demographics
NPI:1851331920
Name:STERN, JAMES DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1483 COMMODORE WAY
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-5062
Mailing Address - Country:US
Mailing Address - Phone:954-234-3899
Mailing Address - Fax:954-653-1472
Practice Address - Street 1:2699 STIRLING RD STE B101
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-6546
Practice Address - Country:US
Practice Address - Phone:954-989-5001
Practice Address - Fax:954-653-1472
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0057379208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL378408800Medicaid
FL27466Medicare ID - Type Unspecified
FLG09343Medicare UPIN