Individual
DR. GARY R STERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLONIAL WAY, JESUP, GA 31545-0130
(912) 427-8177
(912) 427-8365
Mailing address
320 PEACHTREE ST, JESUP, GA 31545-0244
(912) 427-7790
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
072453
GA
207RC0000X
Cardiovascular Disease Physician
174275
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003150982A
—
GA
05
—
01420593
—
NY
01
—
P00272416
CHS RAILROAD MEDICARE
NY
Enumeration date
06/23/2006
Last updated
11/13/2014
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