Healthcare Provider Details

I. General information

NPI: 1093726259
Provider Name (Legal Business Name): DR. RONALD SNYDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 LAKESHORE DRIVE
ISHPEMING MI
49849
US

IV. Provider business mailing address

1233 N 30TH ST
BILLINGS MT
59101-0127
US

V. Phone/Fax

Practice location:
  • Phone: 906-485-2686
  • Fax: 906-485-2725
Mailing address:
  • Phone: 906-485-2686
  • Fax: 906-485-2725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301056070
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301056070
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number27617
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301056070
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: