Provider Demographics
NPI:1043376627
Name:SHAPIRO, RALPH SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:SCOTT
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15700 37TH AVE N
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-3399
Mailing Address - Country:US
Mailing Address - Phone:763-577-0008
Mailing Address - Fax:763-577-0192
Practice Address - Street 1:15700 37TH AVE N
Practice Address - Street 2:SUITE 110
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-3399
Practice Address - Country:US
Practice Address - Phone:763-577-0008
Practice Address - Fax:763-577-0192
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28431207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN51B55SHOtherBLUE CROSS BLUE SHIELD
MN3600132OtherMEDICA
MN882883100Medicaid
MN51B55SHOtherBLUE CROSS BLUE SHIELD
MND82015Medicare UPIN