MEDICARE: RONALD LAWRENCE SHAPIRO MD

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	207R00000X	Internal Medicine Physician	35092	MN

General Provider Information

NPI Number	:	1518166891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD LAWRENCE SHAPIRO MD

Provider Business Mailing Address
First Line	:	5270 W 84TH ST
Second Line	:	#500
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55437
Country	:	US
Telephone Number	:	612-669-7442
Fax Number	:	952-834-8727

Provider Business Practice Location Address
First Line	:	5270 W 84TH ST
Second Line	:	#500
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55437
Country	:	US
Telephone Number	:	612-669-7442
Fax Number	:	952-834-8727

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	07/16/2007

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