Healthcare Provider Details

I. General information

NPI: 1790824258
Provider Name (Legal Business Name): BERNARD MELVIN SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11125 ROCKVILLE PIKE SUITE 206
NORTH BETHESDA MD
20852
US

IV. Provider business mailing address

11125 ROCKVILLE PIKE SUITE 206
NORTH BETHESDA MD
20852
US

V. Phone/Fax

Practice location:
  • Phone: 301-881-7554
  • Fax: 301-230-2943
Mailing address:
  • Phone: 301-881-7554
  • Fax: 301-230-2943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0001737
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101018900
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: