Provider Demographics
NPI:1285168740
Name:STERN, DANIEL WILLIAM FEATHER (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:WILLIAM FEATHER
Last Name:STERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 WALKER SQ APT 2C
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-3468
Mailing Address - Country:US
Mailing Address - Phone:571-438-1070
Mailing Address - Fax:
Practice Address - Street 1:1200 NORTH STATE STREET
Practice Address - Street 2:BLDG. D&T, SUITE 3D321
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089
Practice Address - Country:US
Practice Address - Phone:323-409-7257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101264983208D00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice