Provider Demographics
NPI:1295763977
Name:SHAPIRO, DAVID HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWARD
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 1:561 S DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-6255
Mailing Address - Country:US
Mailing Address - Phone:727-724-4279
Mailing Address - Fax:727-400-6882
Practice Address - Street 1:561 S DUNCAN AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-6255
Practice Address - Country:US
Practice Address - Phone:727-724-4279
Practice Address - Fax:727-400-6882
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME24748208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLNPI 1679878417OtherMEDICARE EO655A
FL271233400Medicaid
FL1295763977OtherMEDICARE 51053X
FL1295763977OtherMEDICARE 51053X
FL51053YMedicare ID - Type UnspecifiedMEDICARE