Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD21878 | OR |
NPI | 1144218231 |
---|---|
Provider Name | Paul Lockwood Sternenberg III |
First Address | Medford, OR 97504-8343 |
Second Address | Medford, OR 97504-8343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 13/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
134081 | (05) | OR |
G99522 | (02) |