Provider Demographics
NPI:1215923503
Name:SHAPIRO, G. ADAM I (DPM)
Entity type:Individual
Prefix:DR
First Name:G.
Middle Name:ADAM
Last Name:SHAPIRO
Suffix:I
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16623 BIRKDALE COMMONS PKWY
Mailing Address - Street 2:STE 120
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5621
Mailing Address - Country:US
Mailing Address - Phone:704-892-5575
Mailing Address - Fax:704-892-6566
Practice Address - Street 1:15419 HODGES CIR STE 200
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6558
Practice Address - Country:US
Practice Address - Phone:704-892-5575
Practice Address - Fax:704-892-6566
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC406213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7809007Medicaid
NC2433282Medicare ID - Type Unspecified
NC7809007Medicaid