Provider Demographics
NPI:1720268162
Name:RICHARD J. STERNBERG MD, FAAOS, P.A.
Entity Type:Organization
Organization Name:RICHARD J. STERNBERG MD, FAAOS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:STERNBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-629-7900
Mailing Address - Street 1:1200 NORMAN ESKRIDGE HWY
Mailing Address - Street 2:PO BOX 419
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-1726
Mailing Address - Country:US
Mailing Address - Phone:302-629-7900
Mailing Address - Fax:302-629-2099
Practice Address - Street 1:1200 NORMAN ESRIDGE HWY
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-1726
Practice Address - Country:US
Practice Address - Phone:302-629-7900
Practice Address - Fax:302-629-2099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005745174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000983201OtherMEDICAID INDV. NUMBER
DE1568401305OtherNPI INDIVIDUAL NUMBER
DE1000015377OtherMEDICAID GROUP NUMBER
DE00B313R53OtherMEDICARE INDV. NUMBER
DEG00953OtherMEDICARE GROUP NUMBER
DE207X00000XOtherMEDICAID TAXONOMY NUMBER
DEG00953OtherMEDICARE GROUP NUMBER
DE1568401305OtherNPI INDIVIDUAL NUMBER