MEDICARE: MICHAEL M. HENINGER M.D.

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	207ZF0201X	Forensic Pathology Physician	040097	GA
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	040097	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	040097	OTHER	GA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1447200852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL M. HENINGER M.D.

Provider Business Mailing Address
First Line	:	530 PRYOR ST SW
Second Line	:	FULTON COUNTY MEDICAL EXAMINERS OFFICE
City	:	ATLANTA
State	:	GA
Zip	:	30312-2718
Country	:	US
Telephone Number	:	404-730-4400
Fax Number	:	404-730-4405

Provider Business Practice Location Address
First Line	:	530 PRYOR ST SW
Second Line	:	FULTON COUNTY MEDICAL EXAMINERS OFFICE
City	:	ATLANTA
State	:	GA
Zip	:	30312-2718
Country	:	US
Telephone Number	:	404-730-4400
Fax Number	:	404-730-4405

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

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	09/11/2025

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