Healthcare Provider Details

I. General information

NPI: 1568063196
Provider Name (Legal Business Name): MADELEINE HOLDEN SNIDOW PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 DOWNWOOD CIR NW
ATLANTA GA
30327-1610
US

IV. Provider business mailing address

3760 REEDS LANDING CIR
MIDLOTHIAN VA
23113-1369
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-6880
  • Fax:
Mailing address:
  • Phone: 804-971-5669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1754
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12719
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: