Healthcare Provider Details

I. General information

NPI: 1962406553
Provider Name (Legal Business Name): DONALD PAUL SNYDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2005
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N MAIN ST
RUSHVILLE IN
46173-1116
US

IV. Provider business mailing address

1300 N MAIN ST
RUSHVILLE IN
46173-1116
US

V. Phone/Fax

Practice location:
  • Phone: 765-932-7075
  • Fax: 812-932-7076
Mailing address:
  • Phone: 765-932-7075
  • Fax: 812-932-7076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01036068A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: