Individual
MELISSA D WILLENBORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 HOFFMAN ST, ELMIRA, NY 14905-2263
(319) 356-2383
(319) 356-6754
Mailing address
571 SAINT JOSEPHS BLVD, FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
292281
NY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
40542
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05029332
—
NY
Enumeration date
05/03/2007
Last updated
04/27/2018
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