Healthcare Provider Details

I. General information

NPI: 1578654042
Provider Name (Legal Business Name): STUART R SNYDER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 DARNESTOWN RD # 101
GAITHERSBURG MD
20878
US

IV. Provider business mailing address

10810 DARNESTOWN RD SUITE #101
GAITHERSBURG MD
20878-2675
US

V. Phone/Fax

Practice location:
  • Phone: 301-762-3338
  • Fax: 301-762-1585
Mailing address:
  • Phone: 301-762-3338
  • Fax: 301-762-1585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number00641
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: