MEDICARE: DR. ELAINE JANET SHAPIRO DPM

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	213E00000X	Podiatrist	0174	AZ

General Provider Information

NPI Number	:	1972525517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELAINE JANET SHAPIRO DPM

Provider Business Mailing Address
First Line	:	1625 W INA RD
Second Line	:	STE 117
City	:	TUCSON
State	:	AZ
Zip	:	85704-1975
Country	:	US
Telephone Number	:	520-297-1366
Fax Number	:	520-297-0129

Provider Business Practice Location Address
First Line	:	1625 W INA RD
Second Line	:	STE 117
City	:	TUCSON
State	:	AZ
Zip	:	85704-1975
Country	:	US
Telephone Number	:	520-297-1366
Fax Number	:	520-297-0129

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	10/27/2011

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