Provider Demographics
NPI:1336157460
Name:STERN, LAURA R (MD)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:R
Last Name:STERN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6100 PAN AMERICAN FREEWAY, NE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3401
Mailing Address - Country:US
Mailing Address - Phone:505-823-1805
Mailing Address - Fax:505-823-1844
Practice Address - Street 1:7850 JEFFERSON ST NE STE 300
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4314
Practice Address - Country:US
Practice Address - Phone:505-884-1114
Practice Address - Fax:505-884-3004
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2022-12-28
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Provider Licenses
StateLicense IDTaxonomies
NM92-360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM009V68OtherBCBS
NM00001944Medicaid
NM202000103OtherPHP
NM1944Medicaid
F51902Medicare UPIN