Individual
DR. MICHELLE RENE BUCKNOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1011 ROCK QUARRY RD, RALEIGH, NC 27610-3825
(919) 833-3111
(919) 834-3118
Mailing address
1001 ROCK QUARRY RD, RALEIGH, NC 27610-3825
(919) 833-3111
(919) 834-3118
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
04-24685
KS
208000000X
Pediatrics Physician
104778
KS
208000000X
Pediatrics Physician
2015-01972
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100147720B
—
KS
01
—
2015-01972
MEDICAL LICENSE
NC
Enumeration date
04/25/2006
Last updated
03/07/2023
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