Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Christian Provenza

Individual provider Emergency Medicine Physician · NPI 1659906741

Christian Provenza is an Emergency Medicine Physician in Indianapolis, Indiana. Practices as a sole proprietor and works from 3 locations. Licensed in Indiana and Tennessee.

Licensed in
IN, TN
In the registry since
2020
Specialties on file
2

Practice location Address checks out

1120 W Michigan Street Gatch Hall Ofc CL 285
Indianapolis, IN 46202
Phone: (317) 278-0042
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 877 Jefferson Ave, Memphis, TN 38103-2807 — (901) 545-7100
  • 1265 Union Ave, Memphis, TN 38104-3415 — (901) 516-7000

Specialties & licences

Critical Care Medicine (Internal Medicine) Physician (primary) Taxonomy 207RC0200X · Licence 01096646A (IN)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 67438 (TN)

Record details

NPI number1659906741
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 9, 2020
Last updated in NPPESJuly 11, 2025
Certification dateJune 27, 2025

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