Healthcare Provider Details

I. General information

NPI: 1245468362
Provider Name (Legal Business Name): MELISSA DEBORRA ROBEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA DEBORRA RODGERS-ROBEY MD

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 WAIANUENUE AVE
HILO HI
96720-2094
US

IV. Provider business mailing address

490 MOHOULI ST
HILO HI
96720-4050
US

V. Phone/Fax

Practice location:
  • Phone: 808-932-3730
  • Fax:
Mailing address:
  • Phone: 503-915-9046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22504
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD157670
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberML60092791
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: