Healthcare Provider Details

I. General information

NPI: 1902244353
Provider Name (Legal Business Name): TRAVIS SNYDER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 03/10/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MEDICAL PARK DR.
ASHEVILLE NC
28803-2493
US

IV. Provider business mailing address

18 MEDICAL PARK DR.
ASHEVILLE NC
28803-2493
US

V. Phone/Fax

Practice location:
  • Phone: 828-253-7521
  • Fax: 828-251-5992
Mailing address:
  • Phone: 828-253-7521
  • Fax: 828-251-5992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-07304
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-07304
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: