Healthcare Provider Details

I. General information

NPI: 1417989120
Provider Name (Legal Business Name): DAN G SNOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 11/17/2022
Certification Date: 11/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14039 CRESTED MOSS CT
RENO NV
89511-6102
US

IV. Provider business mailing address

PO BOX 17892
RENO NV
89511-1033
US

V. Phone/Fax

Practice location:
  • Phone: 775-853-7669
  • Fax: 855-313-0186
Mailing address:
  • Phone: 775-853-7669
  • Fax: 855-313-0186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberNV14778
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: