Healthcare Provider Details

I. General information

NPI: 1063579811
Provider Name (Legal Business Name): ROBERT A SHAPIRO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE ML 3008
CINCINNATI OH
45229-3039
US

IV. Provider business mailing address

3333 BURNET AVE ML 3008
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-7233
  • Fax: 513-636-0204
Mailing address:
  • Phone: 513-636-7233
  • Fax: 513-636-0204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080C0008X
TaxonomyChild Abuse Pediatrics Physician
License Number35.050579
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: