Provider Demographics
NPI:1275736902
Name:POINTER, MELANIE JOHNSON (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:JOHNSON
Last Name:POINTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:JEANNINE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3423 COVINGTON DR
Mailing Address - Street 2:STE B
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1837
Mailing Address - Country:US
Mailing Address - Phone:404-286-9252
Mailing Address - Fax:
Practice Address - Street 1:920 DANNON VW SW
Practice Address - Street 2:SUITE 3202
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2157
Practice Address - Country:US
Practice Address - Phone:404-346-3471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA680372084P0800X, 2084P0804X
NC2012-013822084P0800X, 2084P0804X
HIMD-173572084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry