MEDICARE: DR. MELINA MCSWIGGEN HENDERSON DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	5151014097	MI
2	207V00000X	Obstetrics & Gynecology Physician	93932	GA

General Provider Information

NPI Number	:	1306407556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELINA MCSWIGGEN HENDERSON DO

Provider Business Mailing Address
First Line	:	1538 13TH AVE STE C200
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2546
Country	:	US
Telephone Number	:	706-320-2547
Fax Number	:	706-320-2549

Provider Business Practice Location Address
First Line	:	1538 13TH AVE STE C200
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2546
Country	:	US
Telephone Number	:	706-320-2547
Fax Number	:	706-320-2549

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2019
Last Update Date	:	09/20/2023

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