MEDICARE: MELVYN F 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	208000000X	Pediatrics Physician	D0010302	MD
2	2080A0000X	Pediatric Adolescent Medicine Physician	D0010302	MD

General Provider Information

NPI Number	:	1366761678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVYN F SHAPIRO MD

Provider Business Mailing Address
First Line	:	10801 LOCKWOOD DR STE 325
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-1589
Country	:	US
Telephone Number	:	301-754-3050
Fax Number	:	301-681-0789

Provider Business Practice Location Address
First Line	:	10801 LOCKWOOD DR STE 325
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901-1559
Country	:	US
Telephone Number	:	301-754-3050
Fax Number	:	301-618-0789

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

Provider Enumeration Date	:	05/26/2010
Last Update Date	:	07/10/2012

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