Healthcare Provider Details

I. General information

NPI: 1053762682
Provider Name (Legal Business Name): AMIR SOHEIL TOLEBEYAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AMIR SOHEIL TOLEBEYAN MD

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION ST STE 2D
NATICK MA
01760-4759
US

IV. Provider business mailing address

10 UNION ST STE 2D
NATICK MA
01760-4759
US

V. Phone/Fax

Practice location:
  • Phone: 314-449-5866
  • Fax: 978-953-5646
Mailing address:
  • Phone: 314-449-5866
  • Fax: 978-953-5646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number73646
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberR4357
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number64403
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number73646
License Number StateWI
# 5
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2016020259
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number290838
License Number StateMA
# 8
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number342078
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: