Provider Demographics
NPI:1902967961
Name:SHAPIRO, SCOTT DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DAVID
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5530 WISCONSIN AVE STE 527
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-4430
Mailing Address - Country:US
Mailing Address - Phone:301-654-1059
Mailing Address - Fax:301-654-3761
Practice Address - Street 1:5530 WISCONSIN AVE STE 527
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-4430
Practice Address - Country:US
Practice Address - Phone:301-656-5050
Practice Address - Fax:301-654-3761
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0070911207RC0000X, 207RC0001X
DCMD040017207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI36172Medicare UPIN