Healthcare Provider Details

I. General information

NPI: 1053423269
Provider Name (Legal Business Name): ROBERT CHARLES SNYDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN ROAD
SILVER SPRING MD
20910-1483
US

IV. Provider business mailing address

PO BOX 2070
GERMANTOWN MD
20875-2070
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7335
  • Fax:
Mailing address:
  • Phone: 240-364-2515
  • Fax: 240-566-1605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0038793
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: