Individual
DR. BRIAN CHARLES SHIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1915 S 17TH ST, SUITE 100, WILMINGTON, NC 28401-6681
(910) 362-9511
Mailing address
PO BOX 20169, ROANOKE, VA 24018-0506
(540) 767-2700
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
30859
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220012149
RAILROAD MEDICARE
—
01
—
75966
BCBS OF NC
NC
05
—
8975966
—
NC
05
—
Q30859
—
SC
Enumeration date
10/12/2005
Last updated
07/30/2008
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