Healthcare Provider Details

I. General information

NPI: 1528128352
Provider Name (Legal Business Name): FAITH CARIN SHAPIRO DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 WYOMING BLVD NE SUITE C
ALBUQUERQUE NM
87112-2821
US

IV. Provider business mailing address

1903 WYOMING BLVD NE SUITE C
ALBUQUERQUE NM
87112-2821
US

V. Phone/Fax

Practice location:
  • Phone: 505-298-7666
  • Fax: 505-296-0464
Mailing address:
  • Phone: 505-298-7666
  • Fax: 505-296-0464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number175
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: