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General NPI Number Information
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NPI Number | 1093907404
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Entity Type | Organization
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Legal Business Name | JACK L SNITZER, D.O., P.A.
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 08/10/2007
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Provider Practice Location Address
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Address Line | 1415 S DIVISION ST STE A
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City | SALISBURY
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State | MD
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Zip | 21804-7291
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Country | US
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Telephone | 410-572-8848
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Fax | 410-572-6890
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Provider Business Mailing Address
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Address Line | 1415 S DIVISION ST STE A
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City | SALISBURY
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State | MD
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Zip | 21804-7291
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Country | US
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Telephone | 410-572-8848
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Fax | 410-572-6890
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Authorized Official
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Title or Position | OWNER
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Name | JACK L SNITZER
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Credential | D.O.
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Telephone | 410-572-8848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | H44532
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License Number State | MD
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