Individual
JULIA R PROVCHY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2600 SIXTH ST SW, CANTON, OH 44710-1702
(330) 363-6223
Mailing address
2600 SIXTH ST SW, CANTON, OH 44710-1702
(330) 363-6223
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
35.142300
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/16/2017
Last updated
08/29/2022
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