Provider Demographics
NPI:1932503810
Name:MARIANAS MEDICAL CENTER
Entity Type:Organization
Organization Name:MARIANAS MEDICAL CENTER
Other - Org Name:ANTHONY STEARNS, MD
Other - Org Type:Other Name
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:KWON
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:670-234-3925
Mailing Address - Street 1:PO BOX 5006
Mailing Address - Street 2:CHRB JKR BLG., BEACH ROAD
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-5006
Mailing Address - Country:US
Mailing Address - Phone:670-234-3925
Mailing Address - Fax:670-234-3950
Practice Address - Street 1:JKR BLG., BEACH RD.
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-5006
Practice Address - Country:US
Practice Address - Phone:670-234-3925
Practice Address - Fax:670-234-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-21
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MPNP14004261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care