Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 28898 | NC |
NPI | 1003843608 |
---|---|
Provider Name | Dr. Solomon Shapiro |
First Address | Halifax, NC 27839-0010 |
Second Address | Halifax, NC 27839-0010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 06/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C02415 | (02) | NC |