Provider Demographics
NPI:1649461534
Name:HENDERSON, ZSAKEBA (MD)
Entity type:Individual
Prefix:DR
First Name:ZSAKEBA
Middle Name:
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30016-9085
Mailing Address - Country:US
Mailing Address - Phone:770-262-1254
Mailing Address - Fax:
Practice Address - Street 1:25 PROVIDENCE DR
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30016-9085
Practice Address - Country:US
Practice Address - Phone:770-788-7205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054740207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology