Provider Demographics
NPI:1841223757
Name:MCDONALD, MELINDA SCHILLINGER (PT)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:SCHILLINGER
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4164 W SHORE CT
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-3640
Mailing Address - Country:US
Mailing Address - Phone:770-949-2261
Mailing Address - Fax:770-949-6966
Practice Address - Street 1:6095 PROFESSIONAL PKWY
Practice Address - Street 2:SUITE B-203
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-5607
Practice Address - Country:US
Practice Address - Phone:770-949-2261
Practice Address - Fax:770-949-6966
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT0077462251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52187932003OtherBCBS MARIETTA LOCATION
GA52187932004OtherBCBS WOODSTOCK LOCATION
GA52187932002OtherBCBS DOUGLASVILLE LOCATIO
GA52187932001OtherBCBS AUSTELL LOCATION
GA52187932001OtherBCBS AUSTELL LOCATION
GA65BBDBVMedicare ID - Type Unspecified