Provider Demographics
NPI:1184691685
Name:BUCKLEY, MICHAEL FRANCIS (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:BUCKLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4414 LAKE BOONE TRAIL
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607
Mailing Address - Country:US
Mailing Address - Phone:919-781-7450
Mailing Address - Fax:919-781-6355
Practice Address - Street 1:4414 LAKE BOONE TRAIL
Practice Address - Street 2:# 308 CAPITAL AREA OB GYN
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607
Practice Address - Country:US
Practice Address - Phone:919-781-7450
Practice Address - Fax:919-781-6355
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600377207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5013634OtherAETNA
NC83673OtherMEDCOST
NC89102Medicaid
NC2213426003OtherCIGNA
NC562142486OtherUHC
NC120398OtherWELLPATH
NC1028HOtherBCBS
NC562142486OtherBEECHSTREET
NC2213426003OtherCIGNA
NC83673OtherMEDCOST