Provider Demographics
NPI:1023071792
Name:STERNFELD, MARK DAVID (MD, PHD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:DAVID
Last Name:STERNFELD
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 NW KINGWOOD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-1324
Mailing Address - Country:US
Mailing Address - Phone:541-548-7134
Mailing Address - Fax:541-548-7196
Practice Address - Street 1:236 NW KINGWOOD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1324
Practice Address - Country:US
Practice Address - Phone:541-548-7134
Practice Address - Fax:541-548-7196
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD17315207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORF19086Medicare UPIN
OR132248Medicare PIN