Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 28431 | MN |
NPI | 1043376627 |
---|---|
Provider Name | Dr. Ralph Scott Shapiro |
First Address | Plymouth, MN 55446-3399 |
Second Address | Plymouth, MN 55446-3399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 16/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3600132 | MEDICA (01) | MN |
51B55SH | BLUE CROSS BLUE SHIELD (01) | MN |
882883100 | (05) | MN |
D82015 | (02) | MN |