Healthcare Provider Details

I. General information

NPI: 1174918601
Provider Name (Legal Business Name): MALORIE NICOLE SNIDER OMASTA MD, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MALORIE NICOLE SNIDER MD, LSW

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5780 OAKRIDGE DR
FAIRFIELD TOWNSHIP OH
45011-2144
US

IV. Provider business mailing address

5780 OAKRIDGE DR
FAIRFIELD TOWNSHIP OH
45011-2144
US

V. Phone/Fax

Practice location:
  • Phone: 513-259-1336
  • Fax:
Mailing address:
  • Phone: 832-279-2733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number11401661-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberS.2513066
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: