Provider Demographics
NPI:1558894386
Name:TOBIAS, PAUL B (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:B
Last Name:TOBIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 DANBURY RD STE 180
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-2523
Mailing Address - Country:US
Mailing Address - Phone:203-276-4015
Mailing Address - Fax:203-276-4334
Practice Address - Street 1:372 DANBURY RD STE 180
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-2523
Practice Address - Country:US
Practice Address - Phone:203-276-4015
Practice Address - Fax:203-276-4334
Is Sole Proprietor?:No
Enumeration Date:2017-04-08
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT72265207Q00000X
OH35.138402207Q00000X
NY314218207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program