Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC003898L | PA |
Y | 222Z00000X | Podiatrist | SC003898L | PA |
NPI | 1023067121 |
---|---|
Provider Name | John Michael Snyder |
First Address | Betnel-Park, PA 15102 |
Second Address | Betnel-Park, PA 15102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 22/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001480468 | (05) | PA |
U49632 | (02) |