Provider Demographics
NPI:1437375722
Name:SHAPIRA, NADIV (MD)
Entity Type:Individual
Prefix:
First Name:NADIV
Middle Name:
Last Name:SHAPIRA
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 1:2102 WIND LN
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4053
Mailing Address - Country:US
Mailing Address - Phone:302-561-4202
Mailing Address - Fax:302-654-6110
Practice Address - Street 1:1701 AUGUSTINE CUT OFF
Practice Address - Street 2:SUITE 201
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-4415
Practice Address - Country:US
Practice Address - Phone:302-652-2291
Practice Address - Fax:302-654-6110
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10003224208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG02491C04Medicare PIN