Individual
DR. JACK LEONARD STERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2 E MAIN ST, THURMONT, MD 21788-2006
(301) 271-0554
(240) 288-8395
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(866) 795-4020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001421
VA
152W00000X
Optometrist
OE005427P
PA
152W00000X
Optometrist
OPC1448
FL
152W00000X
Optometrist
Primary
TA0761
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024303500
—
MD
01
—
410046898
RAILROAD MEDICARE
—
01
—
60997503
CAREFIRST BCBS
MD
Enumeration date
12/01/2006
Last updated
11/03/2023
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