MATTHEW J PROVENZANO, M.D.
Medical Practice at Coolspring Ave, Michigan City, IN

License number
Indiana 36490
Category
Medical Practice
Type
Otolaryngology
License number
Indiana 01072216A
Category
Medical Practice
Type
Otolaryngology
License number
Indiana 57.019215
Category
Medical Practice
Type
Pediatric Otolaryngology
License number
Indiana 01072216A
Category
Medical Practice
Type
Pediatric Otolaryngology
Address
Address 2
1225 E Coolspring Ave STE 300, Michigan City, IN 46360
1040 Sierra Dr SUITE 400, Greenwood, IN 46143
Phone
(219) 878-5032
(219) 861-8151 (Fax)
(317) 528-4800
National Provider ID: 1639388911
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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