Provider Demographics
NPI:1528128352
Name:SHAPIRO, FAITH CARIN (DPM)
Entity type:Individual
Prefix:DR
First Name:FAITH
Middle Name:CARIN
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 WYOMING BLVD NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2821
Mailing Address - Country:US
Mailing Address - Phone:505-298-7666
Mailing Address - Fax:505-296-0464
Practice Address - Street 1:1903 WYOMING BLVD NE
Practice Address - Street 2:SUITE C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2821
Practice Address - Country:US
Practice Address - Phone:505-298-7666
Practice Address - Fax:505-296-0464
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM175213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM54577Medicaid
NMNM005354OtherBCBS
NM201009123OtherPRESBYTERIAN
NM54577Medicaid
T41098Medicare UPIN
NM480032773Medicare PIN
NMNM0078Medicare PIN