Provider Demographics
NPI:1104810977
Name:SHIRO, CINDY A (DO)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:A
Last Name:SHIRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 HAMILTON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-1859
Mailing Address - Country:US
Mailing Address - Phone:774-402-8560
Mailing Address - Fax:774-402-8563
Practice Address - Street 1:428 HAMILTON ST FL 2
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-1859
Practice Address - Country:US
Practice Address - Phone:774-402-8560
Practice Address - Fax:774-402-8563
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA156644207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3181871Medicaid
MAA28729Medicare ID - Type Unspecified
MAA2872901Medicare PIN
MAF70070Medicare UPIN