Search › Indiana › 207YP0228X
Matthew Provenzano, M.D
NPI 1639388911 · on the registry since 2007
Practice
- Address
- 1225 E Coolspring Ave Ste 300
Michigan City, IN 46360 - Phone
- (219) 878-5032
- Fax
- (219) 861-8151
- Organisation at this address
- Incremedical Llc
Dunes Optical, Llc
Pharma-Card East, Inc.
Franciscan Physician Network
Lakeshore Eye Consultants, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 58
Registry record
- Primary taxonomy
- 207YP0228X
207YP0228X
- Also registered as
- 207Y00000X
207Y00000X
207YP0228X - Licence states on file
- IN, IA, OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-08-24
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana