Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | 24071 | WI |
Y | 207ND0101X | MOHS-Micrographic Surgeon | MD28318 | OR |
NPI | 1205805405 |
---|---|
Provider Name | Stephen N Snow |
First Address | North Plains, OR 97133-0949 |
Second Address | Portland, OR 97227-1106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 08/03/2013 |