Individual provider · Type 1 NPI

Robert Provenzano, MD

Nephrology Physician · Portland, OR

NPI number 1972505584 Active

Practice location

1547 NE 40th Ave Ste B
Portland, OR 97232-1862

Call (855) 397-0197 Map

Mailing address

1840 E Ray Rd
Chandler, AZ 85225-8720

Specialties and licenses

TaxonomyCodeLicense
Nephrology Physician 207RN0300XM-11205 (ID)
Nephrology Physician 207RN0300X4301047354 (MI)
Nephrology Physician 207RN0300X54729 (AZ)
Nephrology Physician 207RN0300X2017-00405 (NC)
Nephrology Physician 207RN0300X40429 (SC)
Nephrology Physician 207RN0300XMD463387 (PA)
Nephrology Physician 207RN0300XME118456 (FL)
Nephrology Physician 207RN0300X48234 (CO)
Nephrology Physician 207RN0300XMD0000053388 (TN)
Nephrology Physician 207RN0300XMD170613 (OR)
Nephrology Physician Primary 207RN0300XRP047354 (MI)

Nephrology Physician: 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.

3 other providers at this address

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About NPI 1972505584

Robert Provenzano, MD's National Provider Identifier is 1972505584, issued on Aug 12, 2005. The primary taxonomy on file is Nephrology Physician (207RN0300X), and the practice location is in Portland, OR. The record was last updated on Nov 26, 2019.