Provider Demographics
NPI:1821284290
Name:JUNEAU, MICHELLE LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LEIGH
Last Name:JUNEAU
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2045 PEACHTREE RD NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1414
Mailing Address - Country:US
Mailing Address - Phone:404-351-7546
Mailing Address - Fax:404-351-2993
Practice Address - Street 1:2045 PEACHTREE RD NE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1414
Practice Address - Country:US
Practice Address - Phone:404-351-7546
Practice Address - Fax:404-351-2993
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2020-04-30
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Provider Licenses
StateLicense IDTaxonomies
GA63359207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA2021077056Medicare PIN