MEDICARE: IRWIN SHAPIRO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	8102	AZ

General Provider Information

NPI Number	:	1134299795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRWIN SHAPIRO MD

Provider Business Mailing Address
First Line	:	6036 N 19TH AVENUE
Second Line	:	SUITE 206
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2104
Country	:	US
Telephone Number	:	602-242-6248
Fax Number	:	602-242-6264

Provider Business Practice Location Address
First Line	:	6036 N 19TH AVENUE
Second Line	:	SUITE 206
City	:	PHOENIX
State	:	AZ
Zip	:	85015-2104
Country	:	US
Telephone Number	:	602-242-6248
Fax Number	:	602-242-6264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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