Provider Demographics
NPI:1992764203
Name:STEARNS, KIM L (MD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:L
Last Name:STEARNS
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:PO BOX 74977
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44194-0001
Mailing Address - Country:US
Mailing Address - Phone:216-292-0017
Mailing Address - Fax:216-676-5876
Practice Address - Street 1:1730 W 25TH ST FL 6
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3108
Practice Address - Country:US
Practice Address - Phone:216-363-2222
Practice Address - Fax:216-771-5873
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.054573207XS0114X
OH35-05-4573207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0871221Medicaid
OH4202554OtherAETNA
OH000000486922OtherANTHEM BC/BS
OH0871221Medicaid
OH4202554OtherAETNA