Provider Demographics
NPI:1487693487
Name:SHAPIRO, STEPHANIE L (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 MASSACHUSETTS AVENUE
Mailing Address - Street 2:E-23 2 EAST
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01239-4307
Mailing Address - Country:US
Mailing Address - Phone:617-253-0883
Mailing Address - Fax:
Practice Address - Street 1:77 MASSACHUSETTS AVENUE
Practice Address - Street 2:E-23 2 EAST
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01239-4307
Practice Address - Country:US
Practice Address - Phone:617-253-0883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159923207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine