MEDICARE: DR. MARY LEIGH ANNE DANIELS M.D., M.P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	166182	NC
2	208000000X	Pediatrics Physician	166182	NC
3	207RP1001X	Pulmonary Disease Physician	2010-02035	NC

General Provider Information

NPI Number	:	1386656932
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY LEIGH ANNE DANIELS M.D., M.P.H.

Provider Business Mailing Address
First Line	:	300 MEADOWMONT VILLAGE CIR STE 203
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-7518
Country	:	US
Telephone Number	:	984-974-5703
Fax Number	:	984-974-5737

Provider Business Practice Location Address
First Line	:	300 MEADOWMONT VILLAGE CIR STE 203
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27517-7518
Country	:	US
Telephone Number	:	984-974-5703
Fax Number	:	984-974-5737

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	05/22/2019

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