Healthcare Provider Details

I. General information

NPI: 1427581008
Provider Name (Legal Business Name): UDAI SIBIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 MOBILE INFIRMARY CIR STE 305
MOBILE AL
36607-3515
US

IV. Provider business mailing address

3 MOBILE INFIRMARY CIR STE 305
MOBILE AL
36607-3515
US

V. Phone/Fax

Practice location:
  • Phone: 251-625-8200
  • Fax: 443-924-2727
Mailing address:
  • Phone: 251-625-8200
  • Fax: 443-924-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number49773
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number49773
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: