Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 8473 | ME |
NPI | 1164427258 |
---|---|
Provider Name | Dr. Paul Alan Shapero |
First Address | Bangor, ME 04401-5691 |
Second Address | Bangor, ME 04401-5691 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 15/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C66173 | (02) |