Individual
MR. MARK ANTHONY PROVENZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
389 NEW CASTLE RD, BUTLER, PA 16001-1743
(724) 282-2216
(724) 282-1861
Mailing address
PO BOX 1549, BUTLER, PA 16003-1549
(724) 284-5670
(724) 284-4144
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
049161L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0590636
—
PA
01
—
PR873841
HIGHMARK
—
Enumeration date
10/06/2006
Last updated
09/10/2025
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