Provider Demographics
NPI:1225175995
Name:BIRTH AND WOMENS CARE PA
Entity Type:Organization
Organization Name:BIRTH AND WOMENS CARE PA
Other - Org Name:MELVIN L HENDERSON MD PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:FELTON
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-484-3101
Mailing Address - Street 1:104 W SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3218
Mailing Address - Country:US
Mailing Address - Phone:910-875-9700
Mailing Address - Fax:910-875-1048
Practice Address - Street 1:104 W SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3218
Practice Address - Country:US
Practice Address - Phone:910-875-9700
Practice Address - Fax:910-875-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890241BMedicaid
NC890241BMedicaid