Healthcare Provider Details

I. General information

NPI: 1972580199
Provider Name (Legal Business Name): GARY R SNIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 04/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 FRANKLIN ST STE 470
DENVER CO
80218-1128
US

IV. Provider business mailing address

1830 FRANKLIN ST STE 470
DENVER CO
80218-1128
US

V. Phone/Fax

Practice location:
  • Phone: 303-860-7900
  • Fax: 303-839-5367
Mailing address:
  • Phone: 303-860-7900
  • Fax: 303-839-5367

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number27042
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: