Individual
GLEN DAVID SHAPIRO
Active
Individual
GLEN DAVID SHAPIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
M9172
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001364855
—
ID
01
—
100000294843
REGENCE
ID
01
—
11289122
PTAN
ID
01
—
B6493
BCID
ID
01
—
P00247850
RAILROAD MEDICARE
ID
Enumeration date
02/19/2007
Last updated
05/23/2012
Update your record
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