Matthew Provenzano, M.D.
NPI 1639388911 belongs to Matthew Provenzano, M.D., a pediatric otolaryngology physician with a practice location in Michigan City, IN. The NPI was issued on May 22, 2007, and the record was last updated in NPPES on August 24, 2023. The record lists 4 taxonomy codes.
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Otolaryngology Physician Primary | 207YP0228X | 01072216A (IN) |
| Otolaryngology Physician | 207Y00000X | 01072216A (IN) |
| Otolaryngology Physician | 207Y00000X | 36490 (IA) |
| Pediatric Otolaryngology Physician | 207YP0228X | 57.019215 (OH) |
Practice location
Michigan City, IN 46360-6312
Local context
Active NPPES records list 1 provider with pediatric otolaryngology physician as the primary taxonomy within 25 miles of this practice location's ZIP code.
The same primary taxonomy is listed by 11 in Indiana and 851 nationwide.
These are counts from NPPES records, not a ranking or recommendation. Distances are measured between ZIP code centers, not street addresses.
Record history
- Name on record
- Matthew J Provenzano
- Status
- Active
- NPI issued
- Last updated in NPPES
Is this your record? Updates are made through NPPES, the official National Plan and Provider Enumeration System.
NPPES data as of · Source: CMS NPPES
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