Basic Information
| Provider Information | |||||||||
| NPI: | 1053507715 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STOERNER | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1617 UNIVERSITY BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871021710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5053414148 | ||||||||
| FaxNumber: | 5053459914 | ||||||||
| Practice Location | |||||||||
| Address1: | 1617 UNIVERSITY BLVD NE | ||||||||
| Address2: | |||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871021710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5053414148 | ||||||||
| FaxNumber: | 5053459914 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2007 | ||||||||
| LastUpdateDate: | 05/14/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 6353453-1205 | UT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.