Individual
DR. JONATHAN W MELLEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 19TH AVE SW, WILLMAR, MN 56201-4946
(320) 231-3277
(320) 214-5758
Mailing address
1801 19TH AVE SW, WILLMAR, MN 56201-4946
(320) 231-3277
(320) 214-5758
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
47540
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312128300
—
MN
Enumeration date
02/27/2006
Last updated
10/10/2024
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