Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 0000040894 | TN |
N | 207RC0200X | Critical Care Medicine | 35062210 | OH |
NPI | 1063431674 |
---|---|
Provider Name | Ralph D Snider |
First Address | Johnson City, TN 37604-6035 |
Second Address | Johnson City, TN 37604-6035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 23/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0062986 | (05) | OH |
1063431674 | (05) | NC |
1063431674 | (05) | VA |
1516256 | (05) | TN |
G12392 | (02) | TN |
P00432986 | RAILROAD MEDICARE (01) | TN |