Healthcare Provider Details

I. General information

NPI: 1235489774
Provider Name (Legal Business Name): LEENA SHAHLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 CROOKED CREEK PKWY STE 400
DURHAM NC
27713-8507
US

IV. Provider business mailing address

234 CROOKED CREEK PKWY STE 400
DURHAM NC
27713-8507
US

V. Phone/Fax

Practice location:
  • Phone: 919-385-3000
  • Fax: 919-576-8821
Mailing address:
  • Phone: 919-385-3000
  • Fax: 919-576-8821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2024-00595
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: