Individual
MARK TERRANCE METZDORFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 IVY ST, ELMIRA, NY 14905-1627
(607) 737-7780
(607) 737-7788
Mailing address
722 W WATER ST, ELMIRA, NY 14905-2435
(607) 271-2093
(607) 271-2099
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
271766
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD00029270
WA
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
MD13216
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210476
—
OR
05
—
8303331
—
WA
Enumeration date
08/22/2005
Last updated
11/15/2013
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