Provider Demographics
NPI:1447440367
Name:SHAPIRO, PAUL V (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:V
Last Name:SHAPIRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5270 W 84TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437
Mailing Address - Country:US
Mailing Address - Phone:952-926-0000
Mailing Address - Fax:952-838-8727
Practice Address - Street 1:5270 W 84TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437
Practice Address - Country:US
Practice Address - Phone:952-926-0000
Practice Address - Fax:952-838-8727
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN42359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F96426Medicare UPIN