Stephen Altic, D.O.
Individual provider Active NPI Family Medicine Physician · Columbus, OH
NPI 1790763464 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1790763464
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 34003544 (OH)
- Practice address
- 1550 W 5TH Ave
Columbus, OH 43212-2495 - Phone
- (614) 488-7929
- NPI assigned
- Jan 4, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003544 | OH | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34003544 | OH | Yes |
Addresses
Primary practice location
1550 W 5TH Ave
Columbus, OH 43212-2495
Mailing address
1550 W 5TH Ave
Columbus, OH 43212-2495
Phone (614) 488-7929
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0536941 | Medicaid | OH |
Other providers in Columbus, OH
- Nathan Altherr
- Sarah Elizabeth Altherr
- James E. Althof
- Jillian Ann Althoff
- Abdulrahman Althubaiti
- Mary E Altiero
- Altimate Care Medical Supplies,LLC
- Courtney Erin Altman
- Lejetter Altman
- Sarah E Altman
All providers in Columbus, OH · Family Medicine Physician in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.