Provider Demographics
NPI:1669510178
Name:SHAPIRO, DAVID ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ADAM
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2347 BROCKETT ROAD
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4474
Mailing Address - Country:US
Mailing Address - Phone:770-938-4606
Mailing Address - Fax:404-231-9953
Practice Address - Street 1:2347 BROCKETT ROAD
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084
Practice Address - Country:US
Practice Address - Phone:770-938-4606
Practice Address - Fax:404-231-9953
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA350055211OtherRAILROAD MEDICARE
GA393551OtherBCBS
GA911976648OtherTAX ID
U69031Medicare UPIN
GA911976648OtherTAX ID