Healthcare Provider Details
I. General information
NPI: 1720158181
Provider Name (Legal Business Name): MATTHEW JAMES SNYDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/09/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
145 SUNSET CT STE 100&201
WEST COLUMBIA SC
29169-2466
US
IV. Provider business mailing address
PO BOX 6069
WEST COLUMBIA SC
29171-6069
US
V. Phone/Fax
- Phone: 803-739-3550
- Fax: 803-739-3546
- Phone: 803-739-3550
- Fax: 803-739-3546
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | DO2463 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 02003148A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 93818 |
| License Number State | SC |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | 93818 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: