Provenzano, Christopher Robert

Provenzano, Christopher Robert is an individual health care provider with primary practice located at 45650 Schoenherr Rd , Shelby Township MI 48315-6033. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Hypertension Specialist. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Provenzano, Christopher Robert can be contacted via phone (586) 286-7800.

Contact Information

Primary practice address
45650 Schoenherr Rd Shelby Township MI 48315-6033
Phone: (586) 286-7800
Fax: (586) 286-7804
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 4301082092 Michigan
Allopathic & Osteopathic Physicians / Hypertension Specialist 207RH0005X 4301082092 Michigan
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 49048 Colorado

Profile Details

NPI number 1982876157
LBN Legal business name Provenzano, Christopher Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2008
Last updated Oct 27th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982876157 NPPES
Michigan Other CP4301082092 STATE LICENSE

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