MEDICARE: DR ROBERT ALLAN SHAPIRO PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618000517	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0254340001	OTHER	VA	DMEPOS

General Provider Information

NPI Number	:	1245546803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ROBERT ALLAN SHAPIRO PC

Provider Business Mailing Address
First Line	:	7906 B MARSHALL AVENUE
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23605
Country	:	US
Telephone Number	:	757-826-0197
Fax Number	:	757-838-0809

Provider Business Practice Location Address
First Line	:	7906B MARSHALL AVE
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23605-2253
Country	:	US
Telephone Number	:	757-826-0197
Fax Number	:	757-838-0809

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT ALLAN SHAPIRO
Credential	:	O.D.
Telephone Number	:	757-826-0197

Provider Enumeration Date	:	08/20/2010
Last Update Date	:	11/24/2010

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