Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 510031001749 | MI |
NPI | 1013440890 |
---|---|
Provider Name | Adam Snoap |
First Address | Grandville, MI 49418-3232 |
Second Address | Gainesville, FL 32610-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2017 |
Last Update Date | 07/04/2017 |