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NPI Code Detail

MEDICARE: DR. WAYNE EARLE SNYDER M.D.

MEDICARE: DR. WAYNE EARLE SNYDER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207W00000XOphthalmology Physician1496SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21496OTHERSDSTATE LICENSE

General Provider Information

NPI Number : 1053474254
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WAYNE EARLE SNYDER M.D.
Provider Business Mailing Address
First Line : 1225 4TH ST NE
Second Line :
City : WATERTOWN
State : SD
Zip : 57201-1204
Country : US
Telephone Number : 605-882-4175
Fax Number : 605-882-2962
Provider Business Practice Location Address
First Line : 1225 4TH ST NE
Second Line :
City : WATERTOWN
State : SD
Zip : 57201-1204
Country : US
Telephone Number : 605-882-4175
Fax Number : 605-882-2962
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 07/08/2007

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