Individual
DR. THEODORE ALLAN STERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, WRN 605 PSYCHIATRY ASSOCIATES IMPATIENT CONSULT, BOSTON, MA 02114-2696
(617) 726-2984
(617) 726-5946
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2984
(617) 726-5946
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39797
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039797
TUFTS HEALTH PLAN
MA
05
—
2072947
—
MA
01
—
M09860
BCBS MA
MA
Enumeration date
07/11/2006
Last updated
01/02/2013
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