Individual
MEGAN BOISSONNEAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-3049
(404) 712-2000
Mailing address
531 ASBURY CIR STE N340, ATLANTA, GA 30322-1006
(404) 778-2624
(404) 778-6876
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
080054
GA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80054
MEDICAL LICENSE
GA
Enumeration date
04/06/2015
Last updated
07/13/2021
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