Provider Demographics
NPI:1669546727
Name:STERN, WENDY B (MD)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:B
Last Name:STERN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2002
Practice Address - Street 1:299 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-1218
Practice Address - Country:US
Practice Address - Phone:508-973-1350
Practice Address - Fax:508-973-1355
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2016-02-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA76679207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110052105AMedicaid
MA110052105AMedicaid
J13185Medicare ID - Type Unspecified