Healthcare Provider Details

I. General information

NPI: 1013440890
Provider Name (Legal Business Name): ADAM SNOAP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2017
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8402 HARCOURT RD STE 400
INDIANAPOLIS IN
46260-2053
US

IV. Provider business mailing address

250 W 96TH ST STE 520
INDIANAPOLIS IN
46260-1317
US

V. Phone/Fax

Practice location:
  • Phone: 317-338-6815
  • Fax:
Mailing address:
  • Phone: 317-583-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number510031001749
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number01090526A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number510031001749
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: