Provider Demographics
NPI:1881343457
Name:SHOPSHIRE, MATTHEW (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:SHOPSHIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MATTHEW
Other - Middle Name:
Other - Last Name:SHOPSHIRE-GRIFFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1926 DELANO DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1009
Mailing Address - Country:US
Mailing Address - Phone:404-626-1616
Mailing Address - Fax:
Practice Address - Street 1:1133 JOHN FREEMAN BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3412
Practice Address - Country:US
Practice Address - Phone:713-500-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program