Individual
DR. JED SICKLES SHAPIRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1634 WALNUT ST STE 201, BOULDER, CO 80302-5400
(303) 654-7330
(303) 440-6244
Mailing address
888 8TH ST, BOULDER, CO 80302-7409
(303) 654-7330
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
19891
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01198910
—
CO
Enumeration date
07/20/2006
Last updated
02/27/2013
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