Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MT208979 | PA |
Y | 2080P0206X | Pediatric Gastroenterologist | D91603 | MD |
NPI | 1003298167 |
---|---|
Provider Name | Dr. Melissa Lauren Shapiro |
First Address | Baltimore, MD 21215-5231 |
Second Address | Baltimore, MD 21215-5231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2015 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MT208979 | MEDICAL LICENSE (01) | PA |