Healthcare Provider Details

I. General information

NPI: 1093810624
Provider Name (Legal Business Name): PAUL SNIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 W NEWBERRY RD
GAINESVILLE FL
32605-4309
US

IV. Provider business mailing address

PO BOX 409036
ATLANTA GA
30384-9036
US

V. Phone/Fax

Practice location:
  • Phone: 352-333-4900
  • Fax: 904-346-0113
Mailing address:
  • Phone: 352-369-0948
  • Fax: 904-346-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME0047079
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: