Provider Demographics
NPI:1992704514
Name:SHAPIRO, STEVEN LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LOUIS
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 FOREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2507
Mailing Address - Country:US
Mailing Address - Phone:912-352-3338
Mailing Address - Fax:912-691-2969
Practice Address - Street 1:6715 FOREST PARK DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2507
Practice Address - Country:US
Practice Address - Phone:912-352-3338
Practice Address - Fax:912-691-2969
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039938207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000675672FMedicaid
GA20BBDBCOtherMEDICARE ID ASSOCIATED WITH INDIVIDUAL NPI 1992704514
GA709295OtherBCBS
GA300015788EOtherMEDICAID PAYOR NUMBER
GA000675672CMedicaid
GAGRP3391OtherGROUP PTAN
GA202I204789OtherMEDICARE PTAN