Healthcare Provider Details

I. General information

NPI: 1598943292
Provider Name (Legal Business Name): ERIC ROSS SNYDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1104 CASS ST
TRAVERSE CITY MI
49684-3236
US

IV. Provider business mailing address

1104 CASS ST
TRAVERSE CITY MI
49684-3236
US

V. Phone/Fax

Practice location:
  • Phone: 231-941-4502
  • Fax: 231-259-1005
Mailing address:
  • Phone: 231-941-1155
  • Fax: 231-259-1005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number4301097711
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: