Provider Demographics
NPI:1306407556
Name:HENDERSON, MELINA MCSWIGGEN (DO)
Entity Type:Individual
Prefix:DR
First Name:MELINA
Middle Name:MCSWIGGEN
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1538 13TH AVE STE C200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2546
Mailing Address - Country:US
Mailing Address - Phone:706-320-2547
Mailing Address - Fax:706-320-2549
Practice Address - Street 1:1538 13TH AVE STE C200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-2546
Practice Address - Country:US
Practice Address - Phone:706-320-2547
Practice Address - Fax:706-320-2549
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151014097207V00000X
GA93932207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology