Provider Demographics
NPI:1003800921
Name:SHAPIRO, GILBERT D (DPM)
Entity type:Individual
Prefix:
First Name:GILBERT
Middle Name:D
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:GILBERT
Other - Middle Name:D
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM, PC
Mailing Address - Street 1:1888 N COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3115
Mailing Address - Country:US
Mailing Address - Phone:520-327-6367
Mailing Address - Fax:520-318-4492
Practice Address - Street 1:1888 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-3115
Practice Address - Country:US
Practice Address - Phone:520-327-6367
Practice Address - Fax:520-318-4492
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0173213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1003800921OtherNPI
AZ1033469028OtherNPI
AZ701111Medicaid
AZ701111Medicaid
AZ701111Medicaid
AZ1255860001Medicare NSC