Healthcare Provider Details

I. General information

NPI: 1902890247
Provider Name (Legal Business Name): PETER J SNEED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 BUSINESS PARK DR
TRAVERSE CITY MI
49686
US

IV. Provider business mailing address

929 BUSINESS PARK DR
TRAVERSE CITY MI
49686-8683
US

V. Phone/Fax

Practice location:
  • Phone: 231-947-6246
  • Fax: 231-947-8864
Mailing address:
  • Phone: 231-947-6246
  • Fax: 231-947-8864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number4301053615
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number4301053615
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: