Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 21538 | MN |
NPI | 1013981869 |
---|---|
Provider Name | Bruce D Snyder |
First Address | Minneapolis, MN 55425-4516 |
Second Address | Minneapolis, MN 55454-1321 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2006 |
Last Update Date | 20/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
981080300 | (05) | MN |
A94727 | (02) |