Healthcare Provider Details

I. General information

NPI: 1144296708
Provider Name (Legal Business Name): CARL M SHAPIRO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 RAY NORRISH DR
CINCINNATI OH
45246-1520
US

IV. Provider business mailing address

440 RAY NORRISH DR
CINCINNATI OH
45246-1520
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-5548
  • Fax: 513-791-5549
Mailing address:
  • Phone: 513-791-5548
  • Fax: 513-791-5549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number34-006632
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: