Shapiro, Glen David

Shapiro, Glen David is an sole proprietor health care provider with primary practice located at 513 N Main St , Hailey ID 83333. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Shapiro, Glen David can be contacted via phone (877) 754-6330.

Contact Information

Primary practice address
513 N Main St Hailey ID 83333
Phone: (877) 754-6330
Fax: (877) 993-1515
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X M9172 Idaho

Profile Details

NPI number 1336283779
LBN Legal business name Shapiro, Glen David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 19th, 2007
Last updated May 23rd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336283779 NPPES
Idaho Other 100000294843 REGENCE
Idaho MEDICAID 0001364855 REGENCE
Idaho Other 11289122 REGENCE
Idaho Other B6493 REGENCE
Idaho Other B6493 REGENCE
Idaho Other P00247850 REGENCE

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