Basic Information
Provider Information
NPI: 1376769893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STERN
FirstName: ADAM
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3031 NEW BERN AVE
Address2: SUITE 306
City: RALEIGH
State: NC
PostalCode: 276102988
CountryCode: US
TelephoneNumber: 9192313966
FaxNumber: 9192311840
Practice Location
Address1: 3031 NEW BERN AVE
Address2: SUITE 306
City: RALEIGH
State: NC
PostalCode: 276102988
CountryCode: US
TelephoneNumber: 9192313966
FaxNumber: 9192311840
Other Information
ProviderEnumerationDate: 04/17/2007
LastUpdateDate: 03/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RN0300X2009-00669NCY Allopathic & Osteopathic PhysiciansInternal MedicineNephrology

No ID Information.


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