IndividualActive
Christian Provenza
NPI 1659906741 · Critical Care Medicine (Internal Medicine) Physician · Indianapolis, IN
Provider details
- NPI number
- 1659906741
- Entity type
- Individual
- Primary specialty
- Critical Care Medicine (Internal Medicine) PhysicianAllopathic & Osteopathic Physicians
- Sex
- Male
- Sole proprietor
- Yes
- License
- 67438 (TN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1120 West Michigan Street
Gatch Hall Office Cl 285
Indianapolis, IN 46202
Phone: (317) 278-0042
Approximate (ZIP-level) locationGet directions
Mailing address
1120 West Michigan Street
Indianapolis, IN 46202
Additional practice locations (2)
- 877 Jefferson AveMemphis, TN 38103-2807Phone: (901) 545-7100
- 1265 Union AveMemphis, TN 38104-3415Phone: (901) 516-7000
Registry dates
- Enumerated
- 2020-03-09
- Last updated
- 2025-07-11
- Certified
- 2025-06-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.