Basic Information
| Provider Information | |||||||||
| NPI: | 1699790311 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STERN CARDIOVASCULAR CENTER, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8060 WOLF RIVER BLVD | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012712272 | ||||||||
| FaxNumber: | 9012712161 | ||||||||
| Practice Location | |||||||||
| Address1: | 8060 WOLF RIVER BLVD | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381381727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9012712272 | ||||||||
| FaxNumber: | 9012712161 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOLLOWAY | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | H | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9012712272 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.