Healthcare Provider Details

I. General information

NPI: 1528411253
Provider Name (Legal Business Name): SCOTT D. SHAPIRO M.D., PH.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE STE 1248
CHEVY CHASE MD
20815-4301
US

IV. Provider business mailing address

5530 WISCONSIN AVE STE 1248
CHEVY CHASE MD
20815-4301
US

V. Phone/Fax

Practice location:
  • Phone: 301-654-1059
  • Fax: 301-654-3761
Mailing address:
  • Phone: 301-654-1059
  • Fax: 301-654-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0070911
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberD0070911
License Number StateMD

VIII. Authorized Official

Name: DR. SCOTT D SHAPIRO
Title or Position: PRESIDENT
Credential: MD
Phone: 301-654-1059