Provider Demographics
NPI:1801947742
Name:SHAPKIN, MELISSA T (DC)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:T
Last Name:SHAPKIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054
Mailing Address - Country:US
Mailing Address - Phone:508-376-4262
Mailing Address - Fax:508-376-2861
Practice Address - Street 1:840 MAIN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054
Practice Address - Country:US
Practice Address - Phone:508-376-4262
Practice Address - Fax:508-376-2861
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y36218Medicare ID - Type Unspecified