Matthew J Provenzano, MD
Matthew J Provenzano, MD is an Otolaryngology in Michigan City, Indiana. Graduated from Johns Hopkins University School of Medicine in 2004, 22 years ago. Practices with Franciscan Physician Network, a 1,171-clinician group and accepts Medicare assignment. Licensed in Iowa, Indiana and Ohio.
- Years since qualifying
- 22
- Trained at
- Johns Hopkins University School of Medicine
- Licensed in
- IA, IN, OH
- In the registry since
- 2007
- Specialties on file
- 4
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
1225 E Coolspring Ave Ste 300Michigan City, IN 46360-6312
Phone: (219) 878-5032
Fax: (219) 861-8151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatric Otolaryngology Physician (primary) | Taxonomy 207YP0228X · Licence 01072216A (IN) |
|---|---|
| Otolaryngology Physician | Taxonomy 207Y00000X · Licence 01072216A (IN) |
| Otolaryngology Physician | Taxonomy 207Y00000X · Licence 36490 (IA) |
| Pediatric Otolaryngology Physician | Taxonomy 207YP0228X · Licence 57.019215 (OH) |
Record details
| NPI number | 1639388911 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | May 22, 2007 |
| Last updated in NPPES | August 24, 2023 |
| Certification date | August 24, 2023 |
Medicare enrollment
| Medicare specialty | OTOLARYNGOLOGY |
|---|---|
| Medical school | JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE |
| Graduated | 2004 (22 years in practice) |
| Group practice | Franciscan Physician Network — 1171 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Michigan City
-
David Lee Colgrove, MD
1225 E Coolspring Ave Ste 300, Michigan City, IN 46360-6312 · (219) 878-5032
-
David Miller, MD
1225 E Coolspring Ave, Michigan City, IN 46360-6312 · (219) 878-5031
-
William Rosevear, MD
1225 E Coolspring Ave, Michigan City, IN 46360-6312 · (219) 878-5032