1700239167 NPI number — SCOTT D. SHAPIRO, M.D., PH.D., LLC

Table of content: (NPI 1700239167)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700239167 NPI number — SCOTT D. SHAPIRO, M.D., PH.D., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCOTT D. SHAPIRO, M.D., PH.D., LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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 Information

NPI Number:
1700239167
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/08/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5530 WISCONSIN AVE STE 1248
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHEVY CHASE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20815-4301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-654-1059
Provider Business Mailing Address Fax Number:
301-654-3761

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1145 19TH ST NW
Provider Second Line Business Practice Location Address:
SUITE 504
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20036-3701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-654-1059
Provider Business Practice Location Address Fax Number:
301-654-3761
Provider Enumeration Date:
07/20/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SHAPIRO
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-654-1059

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  MD038779 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0001X , with the licence number: MD038779 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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