Healthcare Provider Details
I. General information
NPI: 1548717580
Provider Name (Legal Business Name): JOSHUA P JUNE DO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2016
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4052 LEGACY PKWY STE 200
LANSING MI
48911-4285
US
IV. Provider business mailing address
4052 LEGACY PKWY STE 200
LANSING MI
48911-4285
US
V. Phone/Fax
- Phone: 517-272-9700
- Fax: 517-272-9706
- Phone: 517-272-9700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RR0500X |
| Taxonomy | Rheumatology Physician |
| License Number | 5101018709 |
| License Number State | MI |
VIII. Authorized Official
Name: DR.
JOSHUA
PAUL
JUNE
Title or Position: DIRECTOR
Credential: D.O.
Phone: 616-550-0211