Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Occupational Medicine |
261QX0100X | |||
Primary Care |
261QP2300X | |||
Urgent Care |
261QU0200X |
| NPI # | 1164066015 |
||||
| LBN Legal business name | STERLING PROVIDER GROUP | ||||
| Authorized official | CORBIN BUNNAGE - (PROVIDER/OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 11/04/2019 | ||||
| Last updated | 06/30/2025 - About 11 months ago | ||||
| Identifiers |
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