Provider Demographics
NPI:1285656504
Name:SHAPIRO, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1601 MEDICAL ARTS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-3459
Mailing Address - Country:US
Mailing Address - Phone:765-298-5700
Mailing Address - Fax:765-298-4913
Practice Address - Street 1:1601 MEDICAL ARTS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46011-3459
Practice Address - Country:US
Practice Address - Phone:765-298-5700
Practice Address - Fax:765-298-4913
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01028171A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000313017OtherANTHEM
IN100172440Medicaid
IN213360EMedicare PIN
IND70886Medicare UPIN
INP00112760Medicare PIN
INM400024708Medicare PIN