Provider Demographics
NPI:1144296708
Name:SHAPIRO, CARL M (DO)
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:M
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 RAY NORRISH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-1520
Mailing Address - Country:US
Mailing Address - Phone:513-791-5548
Mailing Address - Fax:513-791-5549
Practice Address - Street 1:440 RAY NORRISH DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-1520
Practice Address - Country:US
Practice Address - Phone:513-791-5548
Practice Address - Fax:513-791-5549
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-0066322081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200142880Medicaid
KY64956790Medicaid
OH2015143Medicaid
OH2015143Medicaid
IN257690AMedicare PIN
OHF98958Medicare UPIN