Doctor Name: | DR. JUSTIN D STERETT |
NPI Number: | 1568690113 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 27 Somdg 208 W. Casablanca Ave Bldg 1400 Cannon Afb, NM - 88103 |
Business Phone Number: | 5757840287 |
Business Fax Number: | |
Mailing Address: | 1400 Fairway Ter, Apt. 18 CLOVIS |
State: | NM |
Postal Code: | 881013085 |
Phone Number: | 6166351025 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2009 |
NPI Last Update Date: | 12/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |