Healthcare Provider Details

I. General information

NPI: 1275899163
Provider Name (Legal Business Name): NAILAH SAFIYA ADAMS MORANCIE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 MAYFAIR ST STE 100
DURHAM NC
27707-6223
US

IV. Provider business mailing address

590 MANNING DR
CHAPEL HILL NC
27599-7595
US

V. Phone/Fax

Practice location:
  • Phone: 984-215-4780
  • Fax: 984-215-4785
Mailing address:
  • Phone: 984-974-4882
  • Fax: 919-966-6125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2024050157
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME120759
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number2020-03395
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: