Healthcare Provider Details

I. General information

NPI: 1851499305
Provider Name (Legal Business Name): DAVID SHAPIRO PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 8TH STREET SUITE 301
COLORADO SPRINGS CO
80906
US

IV. Provider business mailing address

1301 8TH STREET SUITE 301
COLORADO SPRINGS CO
80906
US

V. Phone/Fax

Practice location:
  • Phone: 719-634-6887
  • Fax: 719-630-7858
Mailing address:
  • Phone: 719-634-6887
  • Fax: 719-630-7858

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: