Healthcare Provider Details

I. General information

NPI: 1467580274
Provider Name (Legal Business Name): SCOTT SNYDER DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 S MAIN ST
RED LION PA
17356-2413
US

IV. Provider business mailing address

1560 HILLCROFT LN
YORK PA
17403-4041
US

V. Phone/Fax

Practice location:
  • Phone: 717-244-8666
  • Fax:
Mailing address:
  • Phone: 717-812-8225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC003467R
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: