Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 035769 | GA |
NPI | 1154387074 |
---|---|
Provider Name | Averel B Snyder |
First Address | Marietta, GA 30007-0547 |
Second Address | Atlanta, GA 30342-1701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 12/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000508373F | (05) | GA |
000508373G | (05) | GA |
000508373H | (05) | GA |
00508373D | (05) | GA |
F33507 | (02) | GA |