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NPI Code Detail

MEDICARE: CHARLES STEBNER MOSTELLER M.D.

MEDICARE: CHARLES STEBNER MOSTELLER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician00014530AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10810135OTHERALUNITED HEALTHCARE PROV #
251034523OTHERALBLUE CROSS PROVIDER #
34204103OTHERALAETNA PIN
4E56728OTHERALHEALTHSPRING PROVIDER #

General Provider Information

NPI Number : 1235121492
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES STEBNER MOSTELLER M.D.
Provider Business Mailing Address
First Line : 2880 DAUPHIN ST
Second Line :
City : MOBILE
State : AL
Zip : 36606-2457
Country : US
Telephone Number : 251-341-3368
Fax Number : 251-341-3371
Provider Business Practice Location Address
First Line : 3701 DAUPHIN ST
Second Line :
City : MOBILE
State : AL
Zip : 36608-1756
Country : US
Telephone Number : 251-341-3368
Fax Number : 251-341-3371
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 11/19/2007

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