Healthcare Provider Details
I. General information
NPI: 1235792995
Provider Name (Legal Business Name): VUSALA SNYDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/18/2019
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
415 RAY C HUNT DR STE 2200
CHARLOTTESVILLE VA
22903-2980
US
IV. Provider business mailing address
PO BOX 749112
ATLANTA GA
30374-9112
US
V. Phone/Fax
- Phone: 434-924-5700
- Fax:
- Phone: 434-295-1000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2082S0099X |
| Taxonomy | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician |
| License Number | 0101286069 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 92490 |
| License Number State | SC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | 0101286069 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: