1518957935 NPI number — DR. GILBERT L SHAPIRO MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518957935 NPI number — DR. GILBERT L SHAPIRO MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SHAPIRO

Provider First Name:

GILBERT

Provider Middle Name:

L

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1518957935

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/20/2013

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

200 MILL RD

Provider Second Line Business Mailing Address:

SUITE 180

Provider Business Mailing Address City Name:

FAIRHAVEN

Provider Business Mailing Address State Name:

MA

Provider Business Mailing Address Postal Code:

02719-5252

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

508-973-2000

Provider Business Mailing Address Fax Number:

508-973-2001

Provider First Line Business Practice Location Address:

84 GRAPE ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NEW BEDFORD

Provider Business Practice Location Address State Name:

MA

Provider Business Practice Location Address Postal Code:

02740-2143

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

508-992-4024

Provider Business Practice Location Address Fax Number:

508-997-3940

Provider Enumeration Date:

10/26/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207XX0005X , with the licence number:  25797 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 9727027 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
• Identifier: 22514 . This is a "BOSTON HEALTH NET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 4145-0 . This is a "RHODE ISLAND BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 714246 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 0901011 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: M12882 . This is a "MA BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: B20394401 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 17010 . This is a "HARVARD PILGRIM HEALTH CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: TRICARE . This is a "088-51-N-GI FK" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: 0005462 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
• Identifier: K1120201 . This is a "MEDICARE ID-TYPE UNSPECIFIED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".