JEROME A PROVENZANO

NEWPORT NEWS, VA
NPI1891760039
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: VA  0101048791)
Enumeration Date2006-02-21
Last Update Date2020-02-07
Business Address
JEROME A PROVENZANO MD
12655 WARWICK BLVD
NEWPORT NEWS, VA 23606-2501
Phone number: 757-595-9880
Mailing Address
JEROME A PROVENZANO MD
860 OMNI BLVD STE 101
NEWPORT NEWS, VA 23606-4430
Phone number: 757-232-8769
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