Healthcare Provider Details

I. General information

NPI: 1376530907
Provider Name (Legal Business Name): EVE C SHAPIRO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6060 N FOUNTAIN PLAZA DR 200
TUCSON AZ
85704-7870
US

IV. Provider business mailing address

6060 N FOUNTAIN PLAZA DR 200
TUCSON AZ
85704-7870
US

V. Phone/Fax

Practice location:
  • Phone: 520-797-3888
  • Fax: 520-797-2196
Mailing address:
  • Phone: 520-797-3888
  • Fax: 520-797-2196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number16093
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: