Provider Demographics
NPI:1780688606
Name:SHAPIRO, ADAM MARC (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:MARC
Last Name:SHAPIRO
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:PO BOX 12390
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-5390
Mailing Address - Country:US
Mailing Address - Phone:340-774-8881
Mailing Address - Fax:340-774-1569
Practice Address - Street 1:9149 ESTATE THOMAS
Practice Address - Street 2:STE 308
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-2615
Practice Address - Country:US
Practice Address - Phone:340-774-8881
Practice Address - Fax:340-776-9807
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1208207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI0085416Medicare PIN
VIF38670Medicare UPIN
VI0020888Medicare PIN