Provider Demographics
NPI:1104825629
Name:SHAPIRO, ERIC JB (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:JB
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 1:24701 EUCLID AVE
Mailing Address - Street 2:THIRD FLOOR BILLING SERVICES
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:440-708-1555
Mailing Address - Fax:440-708-1515
Practice Address - Street 1:8185 E WASHINGTON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-4574
Practice Address - Country:US
Practice Address - Phone:440-708-1555
Practice Address - Fax:440-708-1515
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35054257S207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHR54257OtherAPEX & SUMMACARE
OH0829670Medicaid
OHP00185642OtherRAILROAD MEDICARE
OH0829670Medicaid
OHSH0688444Medicare PIN