Individual
DR. ZACHARY JOSEPH PROVENZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-2731
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL92631
SC
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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