Evan P Provisor, MD
Surgery in Southbridge, Massachusetts
1366427429- Practice location
- 94 South St, Southbridge, MA 01550-4000
- Phone
- 508-764-6966
- Fax
- 508-764-2457
- Last updated
- December 21, 2011
Evan Paul Provisor is a Surgery based in Southbridge, MA. Evan Paul Provisor practices in Southbridge, MA and has the professional credentials of MD. The NPI Number for Evan Paul Provisor is 1366427429 and holds a License No. 237945 (MA). The current practice location address for Evan Paul Provisor is 94 South St, Southbridge, MA 01550-4000 and can be reached out via phone at 508-764-6966 and via fax at 508-764-2457.
Provider Profile Details
- NPI Number
- 1366427429
- Provider Name
- Evan Paul Provisor
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 94 South St, Southbridge, MA 01550-4000
- Phone Number
- 508-764-6966
- Fax Number
- 508-764-2457
- Primary Taxonomy
- Surgery · 208600000X
- Sole Proprietor
- No
- Provider Enumeration Date
- December 13, 2005
- Last Update Date
- December 21, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 94 South St
Southbridge, MA 01550-4000 - City
- Southbridge
- State
- Massachusetts
- Zip
- 01550-4000
- Phone Number
- 508-764-6966
- Fax Number
- 508-764-2457
Provider Business Mailing Address Details
- Address
- 94 South St
Southbridge, MA 01550-4000 - City
- Southbridge
- State
- MA
- Zip
- 01550-4000
- Phone Number
- 508-764-6966
- Fax Number
- 508-764-2457
License Information
- License Number
- 237945
- License State
- MA
- Taxonomy
- Surgery · 208600000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Surgery providers near Southbridge, MA
View all Surgery providers in Southbridge →Frequently Asked Questions
What is the NPI number of Evan P Provisor, MD?
The NPI number of Evan P Provisor, MD is 1366427429. It was assigned on December 13, 2005 and is currently active in the NPPES registry.
What is the specialty of Evan P Provisor, MD?
Evan P Provisor, MD is registered under the primary taxonomy Surgery (code 208600000X), licensed in MA under license number 237945.
Where does Evan P Provisor, MD practice?
The practice location is 94 South St, Southbridge, MA 01550-4000. The office can be reached at 508-764-6966 (phone) or 508-764-2457 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1366427429 directly on the NPPES registry website.