Provider Demographics
NPI:1255509733
Name:HELWIG-HENSON, MELECIA K (PA-C)
Entity Type:Individual
Prefix:
First Name:MELECIA
Middle Name:K
Last Name:HELWIG-HENSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 LIGHTHOUSE PT E STE 260
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4791
Mailing Address - Country:US
Mailing Address - Phone:410-801-6575
Mailing Address - Fax:410-801-9672
Practice Address - Street 1:2700 LIGHTHOUSE PT E STE 260
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4791
Practice Address - Country:US
Practice Address - Phone:410-801-6575
Practice Address - Fax:410-801-9672
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003065363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant