Provider Demographics
NPI:1649278714
Name:SHTERNFELD, MICHAEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:SHTERNFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:A
Other - Last Name:SHTERNFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2800 TAMARACK AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5539
Mailing Address - Country:US
Mailing Address - Phone:860-648-0860
Mailing Address - Fax:860-648-0870
Practice Address - Street 1:2800 TAMARACK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5539
Practice Address - Country:US
Practice Address - Phone:860-648-0860
Practice Address - Fax:860-648-0870
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2007-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT040529207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F65629Medicare UPIN