Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ROBERT PROVENZANO, MD
ActiveNephrology · PORTLAND, OR
Registration Details
- NPI Number
- 1972505584
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 12, 2005 (20.758465498112 yrs)
- Last Updated
- Nov 26, 2019
- Licenses
-
M-11205 (ID)4301047354 (MI)54729 (AZ)2017-00405 (NC)40429 (SC)
Practice Information
- Address
-
1547 NE 40TH AVE STE BPORTLAND, OR, 972321862Browse OR providers · Browse ZIP 97232
- Phone
- 8553970197
- Primary Specialty
-
Nephrology
207RN0300X
- Additional Specialty
- Nephrology
- Additional Specialty
- Nephrology
- Additional Specialty
- Nephrology
- Additional Specialty
- Nephrology
Other Nephrology Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| MS. CYNTHIA LOU GABOURY | MD | 1063413276 |
| JEAN K MATHEW | MD | 1497730808 |
| DR. SALLIE E ISRAELIT | MD | 1467439547 |
| PETER B FISHER | MD | 1376520452 |
| ARNOLD H ISRAELIT | MD | 1679551436 |
| TODD R HILBELINK | MD | 1568440584 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.