Healthcare Provider Details

I. General information

NPI: 1730139197
Provider Name (Legal Business Name): MICHELE T. STAUFFENBERG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FULTON COUNTY MEDICAL EXAMINERS OFFICE 430 PRYOR ST.
ATLANTA GA
30312
US

IV. Provider business mailing address

FULTON COUNTY MEDICAL EXAMINERS OFFICE 430 PRYOR ST.
ATLANTA GA
30312
US

V. Phone/Fax

Practice location:
  • Phone: 404-730-4400
  • Fax: 404-730-4405
Mailing address:
  • Phone: 404-730-4400
  • Fax: 404-730-4405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License Number049478
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number049478
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: