EVAN PROVISOR, MD
Surgery
Active
Individual
NPI: 1366427429
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Surgery | 208600000X | Yes | 237945 (MA) |
Frequently Asked Questions
NPI 1366427429 is the National Provider Identifier for EVAN PROVISOR, MD, a Surgery provider located in Southbridge, MA. This NPI was enumerated on December 13, 2005.
EVAN PROVISOR, MD practices at 94 SOUTH ST, Southbridge, MA 01550.
Quick Facts
- NPI
- 1366427429
- Type
- Individual
- Enumerated
- Dec 13, 2005
- Last Updated
- Dec 21, 2011
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