Healthcare Provider Details

I. General information

NPI: 1306889829
Provider Name (Legal Business Name): PETER EDWARD SHAPIRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6675 HOLMES RD SUITE 410
KANSAS CITY MO
64131-1150
US

IV. Provider business mailing address

12521 SHERWOOD DR
LEAWOOD KS
66209-3135
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-2300
  • Fax: 816-361-2392
Mailing address:
  • Phone: 913-327-7363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberR9H34
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: