Provider Demographics
NPI:1518166891
Name:SHAPIRO, RONALD LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:LAWRENCE
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 1:5270 W 84TH ST
Mailing Address - Street 2:#500
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55437
Mailing Address - Country:US
Mailing Address - Phone:612-669-7442
Mailing Address - Fax:952-834-8727
Practice Address - Street 1:5270 W 84TH ST
Practice Address - Street 2:#500
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55437
Practice Address - Country:US
Practice Address - Phone:612-669-7442
Practice Address - Fax:952-834-8727
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN35092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D58888Medicare UPIN