Healthcare Provider Details

I. General information

NPI: 1467458943
Provider Name (Legal Business Name): ALLAN JAMES SHAPIRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N KEENE ST STE 207
COLUMBIA MO
65201-8105
US

IV. Provider business mailing address

PO BOX 843966
KANSAS CITY MO
64184-3966
US

V. Phone/Fax

Practice location:
  • Phone: 573-219-3960
  • Fax: 573-219-3964
Mailing address:
  • Phone: 573-882-3300
  • Fax: 573-884-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberR6H11
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: