Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 1208 | VI |
NPI | 1780688606 |
---|---|
Provider Name | Adam Marc Shapiro |
First Address | St Thomas, VI 00801-5390 |
Second Address | St Thomas, VI 00802-2615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 16/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F38670 | (02) | VI |