Provider Demographics
NPI:1801844006
Name:WILLENBORG, ANNE SCHWIRCK (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:SCHWIRCK
Last Name:WILLENBORG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12A LEDGEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD CENTER
Mailing Address - State:CT
Mailing Address - Zip Code:06250-1664
Mailing Address - Country:US
Mailing Address - Phone:860-423-2960
Mailing Address - Fax:860-423-3719
Practice Address - Street 1:12A LEDGEBROOK DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD CENTER
Practice Address - State:CT
Practice Address - Zip Code:06250-1664
Practice Address - Country:US
Practice Address - Phone:860-423-2960
Practice Address - Fax:860-423-3719
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035631208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics