Basic Information
| Provider Information | |||||||||
| NPI: | 1891748091 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STERN | ||||||||
| FirstName: | SHARON | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4655 DOUGLAS CIRCLE NW | ||||||||
| Address2: | STE 100 | ||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447183673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304995700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4665 DOUGLAS CIR NW | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447183673 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304891698 | ||||||||
| FaxNumber: | 3304891325 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2006 | ||||||||
| LastUpdateDate: | 06/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 35056436 | OH | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 0739053 | 05 | OH | MEDICAID | 050012264 | 01 | MEDICARE RAILROAD | OTHER | 000000135916 | 01 | ANTHEM | OTHER |