Healthcare Provider Details

I. General information

NPI: 1275502320
Provider Name (Legal Business Name): ALEXANDER B SNYDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date: 12/27/2006
Reactivation Date: 05/22/2007

III. Provider practice location address

3369 CLINGMAN RD
RONDA NC
28670-8708
US

IV. Provider business mailing address

1420 E FRANKLIN ST
MONROE NC
28112-5160
US

V. Phone/Fax

Practice location:
  • Phone: 336-984-3003
  • Fax: 336-984-2700
Mailing address:
  • Phone: 704-289-8427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number18575
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: