Provider Demographics
NPI:1861462459
Name:STERNBERG, LAWRENCE (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:STERNBERG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2924 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4443
Mailing Address - Country:US
Mailing Address - Phone:989-631-0200
Mailing Address - Fax:989-631-2210
Practice Address - Street 1:2924 MANOR DR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4443
Practice Address - Country:US
Practice Address - Phone:989-631-0200
Practice Address - Fax:989-631-2210
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI001623213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI485825300OtherBCBSM
MI3333128Medicaid
MI485825300OtherBCBSM