Healthcare Provider Details

I. General information

NPI: 1760495386
Provider Name (Legal Business Name): AMANDA DAWN SNYDER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA DAWN ESKEW PA-C

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AMALIA DR
BUCKHANNON WV
26201-2239
US

IV. Provider business mailing address

1 AMALIA DR
BUCKHANNON WV
26201-2239
US

V. Phone/Fax

Practice location:
  • Phone: 304-473-2066
  • Fax: 304-473-2309
Mailing address:
  • Phone: 304-473-2066
  • Fax: 304-473-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: