Provider Demographics
NPI:1447200852
Name:HENINGER, MICHAEL M (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:HENINGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:530 PRYOR ST SW
Mailing Address - Street 2:FULTON COUNTY MEDICAL EXAMINERS OFFICE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2718
Mailing Address - Country:US
Mailing Address - Phone:404-730-4400
Mailing Address - Fax:404-730-4405
Practice Address - Street 1:530 PRYOR ST SW
Practice Address - Street 2:FULTON COUNTY MEDICAL EXAMINERS OFFICE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2718
Practice Address - Country:US
Practice Address - Phone:404-730-4400
Practice Address - Fax:404-730-4405
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA040097207ZF0201X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA040097OtherMEDICAL LICENSE