CHRISTOPHER ROBERT PROVENZANO (NPI# 1982876157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982876157 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER ROBERT PROVENZANO |
| Credential | MD |
| Practice Address |
45650 Schoenherr Rd Shelby Township MI 48315-6033 |
| Mailing Address |
45640 Schoenherr Rd Suite B Shelby Township MI 48315-6033 |
| Practice Telephone | 5862867800 |
| Practice Fax Number | 5862867804 |
| Mailing Telephone | 5862474300 |
| Mailing Fax Number | 5865326496 |
| Enumeration Date | 2008-03-28 |
| Last Update Date | 2015-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RN0300X |
Internal Medicine Specialization: Nephrology |
49048 | CO | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
4301082092 | MI | Allopathic & Osteopathic Physicians |
| N | 207RH0005X |
Internal Medicine Specialization: Hypertension Specialist |
4301082092 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | STATE LICENSE | CP4301082092 | 01 |
| Street Address |
45650 SCHOENHERR RD |
| City | SHELBY TOWNSHIP |
| State | MI |
| Zip Code | 48315-6033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710102389 | Uzma Rehman Do PC | Orthopaedic Surgery | 45650 Schoenherr Rd, Suite A, Shelby Township, MI 48315-6033 | 2007-04-17 |
| 1780856658 | Suzanne Marlene Dailey | Occupational Therapist | 45650 Schoenherr Rd, Suite B, Shelby Township, MI 48315-6033 | 2008-03-31 |
| 1366614240 | Wendy Constance Stevelinck | Occupational Therapist | 45650 Schoenherr Rd, Suite B, Shelby Township, MI 48315-6033 | 2008-03-31 |
| 1235337262 | Jennifer A Jarzombek | Occupational Therapist | 45650 Schoenherr Rd, Suite A, Shelby Township, MI 48315-6033 | 2007-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649885500 | Steven William Scavone | Counselor | 45660 Schonherr Rd., Shelby Township, MI 48315 | 2020-09-08 |
| 1861039844 | Lauren Nicole Himmel | Physician Assistant | 13051 Michael Dr., Shelby Twp., MI 48315 | 2019-12-09 |
| 1881173763 | Shelby Family Cosmetic & Restorative Dentistry | Dentist | 51221 Schoenherr Road., Suite 102, Shelby Township, MI 48315 | 2018-08-10 |
| 1023594223 | Apex Chiropractic, P.C. | Chiropractor | 51543 Schoenherr Road, Shelby Township, MI 48315 | 2018-07-11 |
| 1053809145 | Bam Management | Clinic/Center | 13433 Hall Road, Utica, MI 48315 | 2018-04-25 |
| 1659723203 | Patricia Gates | Registered Nurse | 23066 Balcombe, Utica, MI 48315 | 2016-07-07 |
| 1124481213 | Jai Shree Umiya Inc | Durable Medical Equipment & Medical Supplies | 13350 24 Mile Rd Ste 300, Shelby Township, MI 48315 | 2016-04-05 |
| 1679931828 | Team Rehabilitation S3, LLC | Physical Therapist | 13350 24 Mile Road, Suite 500, Shelby Township, MI 48315 | 2016-02-03 |
| 1164816484 | Sylvia White | Case Manager/Care Coordinator | 47100 Schoenherr Rd. Suite D, Shelby Township, MI 48315 | 2015-03-25 |
| 1770921389 | Amy Christine Vitale | Speech-Language Pathologist | 14145 Simone Dr., Developing Connections Inc, Shelby Twp, MI 48315 | 2013-06-06 |
| Find all providers in zip 48315 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235351263 | Navkiranjot Brar | Internal Medicine | 45640 Schoenherr Rd, Suite B, Shelby Township, MI 48315-6033 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003440439 | Nephrocare Dialysis, LLC | Internal Medicine | Garden City Hosptial, 6245 Inkster Road, Garden City, MI 48135 | 2020-02-25 |
| 1740823459 | Critical Care Nephrology, PC | Internal Medicine | 333 E Parent Ave, Royal Oak, MI 48067-3748 | 2019-10-25 |
| 1568948537 | Amanda Thelen | Internal Medicine | 405 W Greenlawn Ave Ste 230, Lansing, MI 48910-0812 | 2018-07-12 |
| 1023507357 | James Francis Murphy | Internal Medicine | Hope Medical Clinic 518 Harriet St., Ypsilanti, MI 48197-0311 | 2018-05-02 |
| 1457865354 | Aaa Home Visiting Pllc | Internal Medicine | 1502 Fort St, Detroit, MI 48216 | 2017-11-30 |
| 1982129805 | Abhay Mishra | Internal Medicine | 4160 John R St Ste 908, Detroit, MI 48201-2017 | 2017-08-11 |
| 1326586959 | Alhaji Consultant Pllc | Internal Medicine | 29201 Chateau Ct, Farmington Hills, MI 48334-4112 | 2017-02-02 |
| 1033669445 | T-beyene Hypertension & Kidney Care Plc | Internal Medicine | 4160 John R Ste 1011, Harper Professional Building, Detroit, MI 48201 | 2016-10-10 |
| 1285085860 | Omer Yousif | Internal Medicine | 29829 Telegraph Rd Ste 202, Southfield, MI 48034-7656 | 2016-06-24 |
| 1710378377 | Rawm Vascular Access, Pllc | Internal Medicine | 1540 36th Street. Sw, Wyoming, MI 49509 | 2015-02-17 |
| Find all providers with the same taxonomy | ||||
| City | SHELBY TOWNSHIP |
| Zip Code | 48315 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.