Healthcare Provider Details

I. General information

NPI: 1689637951
Provider Name (Legal Business Name): BRADLEY JAY SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 04/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ZOLLIKERSTRASSE 194
ZURICH CANTON
8008
CH

IV. Provider business mailing address

11995 SINGLETREE LN STE 500
EDEN PRAIRIE MN
55344-5347
US

V. Phone/Fax

Practice location:
  • Phone: 19525951100
  • Fax: 16122944903
Mailing address:
  • Phone: 952-595-1301
  • Fax: 612-294-4903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberM9273
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: