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Matthew J Provenzano, MD
Pediatric Otolaryngology Physician in Michigan City, Indiana
NPI 1639388911

Matthew J Provenzano is a Pediatric Otolaryngology Physician based in Detroit, IN and is specialized in Pediatric Otolaryngology. Matthew J Provenzano practices in Michigan City, IN and has the professional credentials of MD. The NPI Number for Matthew J Provenzano is 1639388911 and holds a License No. 01072216A (Indiana).

The current practice location address for Matthew J Provenzano is 1225 E Coolspring Ave Ste 300, Michigan City, IN and can be reached out via phone at 219-878-5032 and via fax at 219-861-8151.

Location: 1225 E Coolspring Ave Ste 300, Michigan City, IN, 48278-1076
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639388911
Provider Name
Matthew J Provenzano
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1225 E Coolspring Ave Ste 300, Michigan City, IN, 48278-1076
Phone Number
219-878-5032
Fax Number
219-861-8151
Provider Enumeration Date
05/22/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1225 E Coolspring Ave Ste 300
City
Michigan City
State
Indiana
Zip
46360-6312
Phone Number
219-878-5032
Fax Number
219-861-8151
person
Provider Business Mailing Address Details
Address
1225 E Coolspring Ave Ste 300
City
Michigan City
State
Indiana
Zip
46360-6312
Phone Number
219-878-5032
Fax Number
219-861-8151
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
-
Taxonomy
207Y00000X
License No.
36490 (Iowa)
Definition
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Otolaryngology
Speciality
Pediatric Otolaryngology
Taxonomy
207YP0228X
License No.
01072216A (Indiana)
Definition
A pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing.
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