Provider Demographics
NPI:1578690277
Name:GILBERT L. SHAPIRO, M.D. FACS PC
Entity Type:Organization
Organization Name:GILBERT L. SHAPIRO, M.D. FACS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS PC
Authorized Official - Phone:508-992-4024
Mailing Address - Street 1:84 GRAPE ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-2143
Mailing Address - Country:US
Mailing Address - Phone:508-992-4024
Mailing Address - Fax:508-997-3940
Practice Address - Street 1:84 GRAPE ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-2143
Practice Address - Country:US
Practice Address - Phone:508-992-4024
Practice Address - Fax:508-997-3940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25797174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2065924Medicaid
MAB98234Medicare UPIN
MAM12882Medicare ID - Type Unspecified
MA2065924Medicaid