Provider Demographics
NPI:1285841353
Name:SHAPIRO WEISS, GEORGE DAVID (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:DAVID
Last Name:SHAPIRO WEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1018
Mailing Address - Street 2:7 SPRING STREET
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457
Mailing Address - Country:US
Mailing Address - Phone:860-344-9558
Mailing Address - Fax:860-347-6265
Practice Address - Street 1:7 SPRING STREET
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457
Practice Address - Country:US
Practice Address - Phone:860-344-9558
Practice Address - Fax:860-347-6265
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT243322084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry