Healthcare Provider Details

I. General information

NPI: 1124602321
Provider Name (Legal Business Name): PORTIA MPONYANA NLEYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2021
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EASTOWNE DR
CHAPEL HILL NC
27514-2286
US

IV. Provider business mailing address

100 EASTOWNE DR
CHAPEL HILL NC
27514-2286
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-4462
  • Fax:
Mailing address:
  • Phone: 984-974-4462
  • Fax: 919-843-9355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberNLEY-0JUV06
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: