=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154501351
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STUART R SNYDER PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2007
-----------------------------------------------------
Last Update Date | 05/11/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10810 DARNESTOWN RD SUITE #101
-----------------------------------------------------
City | GAITHERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20878-2675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-762-3338
-----------------------------------------------------
Fax | 301-762-1585
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10810 DARNESTOWN RD SUITE #101
-----------------------------------------------------
City | GAITHERSBURG
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20878-2675
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-762-3338
-----------------------------------------------------
Fax | 301-762-1585
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. STUART R SNYDER
-----------------------------------------------------
Credential | DPM
-----------------------------------------------------
Telephone | 301-762-3338
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213E00000X
-----------------------------------------------------
Taxonomy Name | Podiatrist
-----------------------------------------------------
License Number | 00614
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------