Healthcare Provider Details

I. General information

NPI: 1568433928
Provider Name (Legal Business Name): DIEHL M. SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 MAIN ST
BAR HARBOR ME
04609-1648
US

IV. Provider business mailing address

PO BOX 8
BAR HARBOR ME
04609-1625
US

V. Phone/Fax

Practice location:
  • Phone: 207-288-5081
  • Fax: 207-288-8600
Mailing address:
  • Phone: 207-288-5081
  • Fax: 207-288-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD16196
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: