Healthcare Provider Details
I. General information
NPI: 1750692000
Provider Name (Legal Business Name): ALANA SNYDER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/01/2010
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
27351 DEQUINDRE RD
MADISON HEIGHTS MI
48071-3487
US
IV. Provider business mailing address
27351 DEQUINDRE RD
MADISON HEIGHTS MI
48071-3487
US
V. Phone/Fax
- Phone: 248-967-7795
- Fax: 248-967-7794
- Phone: 248-967-7795
- Fax: 248-967-7794
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 5101018700 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | P9737 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: