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General NPI Number Information
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NPI Number | 1871510446
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Entity Type | Individual
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Provider Name | STEFAN ALEXANDROV IANCHULEV MD
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 25 HOSPITAL CENTER BLVD
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-2793
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Country | US
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Telephone | 843-681-6122
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Fax |
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Provider Business Mailing Address
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Address Line | 800 WASHINGTON ST TUFTS MEDICAL CENTER
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City | BOSTON
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State | MA
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Zip | 02111-1552
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Country | US
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Telephone | 617-636-6044
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 235292
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 93710
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD-55145
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License Number State | IA
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