Provider Demographics
NPI:1861492019
Name:STERLING, JEFFREY ADAM (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ADAM
Last Name:STERLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 OLD GALLOWS RD
Mailing Address - Street 2:520
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-3990
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:703-991-0514
Practice Address - Street 1:1840 W ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5704
Practice Address - Country:US
Practice Address - Phone:252-752-2171
Practice Address - Fax:252-758-5104
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1877152W00000X
VA0618001359152W00000X
MN2881152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC093N6OtherBCBS PROV #
NC89093N6Medicaid
NCU95995Medicare UPIN
NC2472957AMedicare ID - Type Unspecified
NC2472957DMedicare ID - Type Unspecified
NC093N6OtherBCBS PROV #
NC89093N6Medicaid
NC2472957CMedicare ID - Type Unspecified
NC2472957EMedicare ID - Type Unspecified
VA00X068M01Medicare ID - Type Unspecified