Evan Paul Provisor in Southbridge - Surgery
Evan Paul Provisor - NPI 1366427429
Evan Paul Provisor is a Surgery in Southbridge, Massachusetts. Evan Paul Provisor practices all healthcare services and medical treatments related to Surgery. The NPI Number for Evan Paul Provisor is 1366427429. The last update date is 2011-12-21.
Evan Paul Provisor's current location address is 94 South St, Southbridge, Massachusetts. You can contact this provider via phone number 5087646966 and fax number 5087642457. The mailing address for Evan Paul Provisor is 94 South St, Southbridge, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Evan Paul Provisor |
|---|---|
| Address | 94 South St, Southbridge, Massachusetts |
| Phone Number | 5087646966 |
| Fax Number | 5087642457 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1366427429 |
|---|---|
| Provider Enumeration Date | 2005-12-13 |
| Last Updated Date | 2011-12-21 |
Provider Mailing Address Detail
| Address | 94 South St |
|---|---|
| City | Southbridge |
| State | Massachusetts (MA) |
| Post Code | 15504000 |
| Phone Number | 5087646966 |
| Fax Number | 5087642457 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 237945 |
|
Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2160307 | MA | -- |
Post Comment/ Review Below
What is the Evan Paul Provisor's unique identification number?
The Evan Paul Provisor has been assigned the NPI (National Provider Identifier) Number 1366427429 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Evan Paul Provisor is physically located?
The Evan Paul Provisor is situated at the following address: 94 South St, Southbridge, MA 15504000.
What is Evan Paul Provisor's area of expertise and its corresponding taxonomy classification?
The Evan Paul Provisor's field of specialization is Surgery, and it falls under the taxonomy code 208600000X, which categorizes healthcare providers based on their areas of practice.
When did Evan Paul Provisor receive its 1366427429 assignment?
The Evan Paul Provisor was assigned its 1366427429 on 2005-12-13, which is the date when this unique identifier was issued to the organization.
When was the information regarding Evan Paul Provisor, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Evan Paul Provisor, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2011-12-21.
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