Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 1999140230 | MO |
NPI | 1073696795 |
---|---|
Provider Name | Dr. Robert A Shapiro |
First Address | Creve Coeur, MO 63141-6820 |
Second Address | Creve Coeur, MO 63141-6820 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |