Healthcare Provider Details

I. General information

NPI: 1295851509
Provider Name (Legal Business Name): DONNA LOUISE SNYDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 11/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7063 COLUMBIA GATEWAY DR
COLUMBIA MD
21046-3429
US

IV. Provider business mailing address

11807 FAR EDGE PATH
COLUMBIA MD
21044-4371
US

V. Phone/Fax

Practice location:
  • Phone: 443-283-1625
  • Fax:
Mailing address:
  • Phone: 410-262-8535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0033046
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: