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Individual

MARK LEON WILLENBRING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
745 VICTORIA ST S, SAINT PAUL, MN 55102-4203
(202) 379-6736
Mailing address
745 VICTORIA ST S, SAINT PAUL, MN 55102-4203
(202) 379-6736

Taxonomy

Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
22040
MN
2084P0800X
Psychiatry Physician
Primary
22040
MN
2084P0802X
Addiction Psychiatry Physician
22040
MN

Other

Enumeration date
03/16/2007
Last updated
10/12/2023
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