Healthcare Provider Details

I. General information

NPI: 1194871186
Provider Name (Legal Business Name): BRUCE STEVEN SHAPIRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 12/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8851 W SAHARA AVE STE # 100
LAS VEGAS NV
89117-5890
US

IV. Provider business mailing address

8851 W SAHARA AVE STE # 100
LAS VEGAS NV
89117-5890
US

V. Phone/Fax

Practice location:
  • Phone: 702-254-1777
  • Fax: 702-228-2678
Mailing address:
  • Phone: 702-254-1777
  • Fax: 702-228-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number5710
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: