Provider Demographics
NPI:1851393987
Name:STERN, GEORGE ARNOLD (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ARNOLD
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 S RESERVE ST
Mailing Address - Street 2:SUITE H
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3105
Mailing Address - Country:US
Mailing Address - Phone:406-543-9200
Mailing Address - Fax:406-543-9222
Practice Address - Street 1:1200 S RESERVE ST
Practice Address - Street 2:SUITE H
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3105
Practice Address - Country:US
Practice Address - Phone:406-543-9200
Practice Address - Fax:406-543-9222
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8180174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0169507Medicaid
MT95001OtherBCBS
MT0035581Medicaid
MT0005120600OtherAETNA
MT4257670002Medicare NSC
MT0035581Medicaid
MT000082448Medicare PIN
MT95001OtherBCBS