Provider Demographics
NPI:1639490048
Name:LEONG, MARTHA ELISABETH (DO, MSCR)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:ELISABETH
Last Name:LEONG
Suffix:
Gender:F
Credentials:DO, MSCR
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Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 MANNING DRIVE
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-4159
Practice Address - Country:US
Practice Address - Phone:984-974-4601
Practice Address - Fax:984-974-7440
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS163662080P0202X
PAOS0182382080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology