Provider Demographics
NPI:1700977626
Name:MICHAEL E SHAPIRO MD LTD
Entity Type:Organization
Organization Name:MICHAEL E SHAPIRO MD LTD
Other - Org Name:TAHOE PAIN CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OF COMPANY
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:775-689-5410
Mailing Address - Street 1:605 SIERRA ROSE DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2359
Mailing Address - Country:US
Mailing Address - Phone:775-689-5410
Mailing Address - Fax:775-689-5431
Practice Address - Street 1:605 SIERRA ROSE DR
Practice Address - Street 2:SUITE 4
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2359
Practice Address - Country:US
Practice Address - Phone:775-689-5410
Practice Address - Fax:775-689-5431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6909174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104387Medicare PIN