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NPI 1962483206

NPI 1962483206 : MICHAEL STEVEN SHAPIRO PH.D. : FAYETTEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1962483206
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    Entity Type          |    Individual 
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    Provider Name        |    MICHAEL STEVEN SHAPIRO PH.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/11/2005
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    Last Update Date     |    01/17/2020
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Provider Practice Location Address
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    Address Line         |    1601 OWEN DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28304-3425
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    Country              |    US
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    Telephone            |    910-678-0100
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    Fax                  |    910-678-7022
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Provider Business Mailing Address
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    Address Line         |    1601 OWEN DR 
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    City                 |    FAYETTEVILLE
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    State                |    NC
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    Zip                  |    28304-3425
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    Country              |    US
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    Telephone            |    910-678-0100
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    Fax                  |    910-678-7022
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    5209
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    License Number State |    NC
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Taxonomy #2
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    Taxonomy Code        |    103TH0100X
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    Taxonomy Name        |    Health Service Psychologist
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    License Number       |    5209
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    License Number State |    NC
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