Provider Demographics
NPI:1497904528
Name:SHAPIRO, JOHN HENRY (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HENRY
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 KERNAN DR
Mailing Address - Street 2:SUITE 1154
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6665
Mailing Address - Country:US
Mailing Address - Phone:410-448-6400
Mailing Address - Fax:410-448-6296
Practice Address - Street 1:2200 KERNAN DR
Practice Address - Street 2:SUITE 1154
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-6665
Practice Address - Country:US
Practice Address - Phone:410-448-6400
Practice Address - Fax:410-448-6296
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01184213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDPENDINGMedicaid
MDPENDINGMedicaid