Provider Demographics
NPI:1730281981
Name:TOBIAS, STEPHEN LESLIE (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LESLIE
Last Name:TOBIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:S.
Other - Middle Name:LESLIE
Other - Last Name:TOBIAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:224 W EXCHANGE ST
Mailing Address - Street 2:#225
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1704
Mailing Address - Country:US
Mailing Address - Phone:330-344-7400
Mailing Address - Fax:330-344-2015
Practice Address - Street 1:224 W EXCHANGE ST
Practice Address - Street 2:#225
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44302-1704
Practice Address - Country:US
Practice Address - Phone:330-344-7400
Practice Address - Fax:330-344-2015
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35061370207RC0000X
OH35-061370207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID #
OH1841239274OtherPARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH0837321Medicaid
OH9338635OtherPARTNERS PHYSICIAN GROUP MEDICARE #
OH1326356346OtherCARDIOVASCULAR & INTERVENTIONAL ASSOCIATES TYPE 2 NPI #
OH1326356346OtherCARDIOVASCULAR & INTERVENTIONAL ASSOCIATES TYPE 2 NPI #
OH0764369Medicare PIN
OH1326356346OtherCARDIOVASCULAR & INTERVENTIONAL ASSOCIATES TYPE 2 NPI #
OH000000233378OtherUNISON