Active NPI
Stefan Ichim, M.D.
- Anesthesiology Physician
- Mobile, AL
National Provider Identifier
1366533739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 20461
- Practice address
- 2451 Fillingim St
Mobile, AL 36617-2238 - Phone
- (251) 471-7035
- Fax
- (251) 472-7042
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 20461 | AL | Primary |
Addresses
Primary practice location
2451 Fillingim St
Mobile, AL 36617-2238
Mailing address
2802 Kings Mill Dr W
Mobile, AL 36693-3322
Phone (251) 662-0397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366533739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2802 KINGS MILL DR W",
"city": "MOBILE",
"state": "AL",
"postal_code": "366933322",
"telephone_number": "251-662-0397",
"fax_number": "251-662-0397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2451 FILLINGIM ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366172238",
"telephone_number": "251-471-7035",
"fax_number": "251-472-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ICHIM",
"first_name": "STEFAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AL",
"license": "20461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.