Individual
AARON SAMUEL PROVISOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1060 FIRST COLONIAL RD, VIRGINIA BEACH, VA 23454-3002
(757) 395-8000
Mailing address
3241 WESTERN BRANCH BLVD, CHESAPEAKE, VA 23321-5260
(757) 967-8622
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35692
SC
208M00000X
Hospitalist Physician
MD35692
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356929
—
SC
Enumeration date
05/03/2010
Last updated
05/21/2025
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