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Individual

ETHAN SAMUEL STERN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
214 PEACH ORCHARD RD, MC CONNELLSBURG, PA 17233-8559
(717) 485-3155
Mailing address
214 PEACH ORCHARD RD, MC CONNELLSBURG, PA 17233-8559
(717) 485-3155

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS020508
PA
207R00000X
Internal Medicine Physician
OT018354
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100742763
PA
Enumeration date
04/11/2018
Last updated
03/12/2021
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