MEDICARE: STEWART CHARLES SNAVELY 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
1	208000000X	Pediatrics Physician	2268	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	CS01050	OTHER	NV	STATE PHARMACY

General Provider Information

NPI Number	:	1215915947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEWART CHARLES SNAVELY M. D.

Provider Business Mailing Address
First Line	:	2040 W CHARLESTON BLVD
Second Line	:	402
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-2227
Country	:	US
Telephone Number	:	702-992-6868
Fax Number	:	702-992-6860

Provider Business Practice Location Address
First Line	:	3006 S MARYLAND PKWY
Second Line	:	315
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2218
Country	:	US
Telephone Number	:	702-992-6868
Fax Number	:	702-992-6860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	03/07/2023

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Directions to “ STEWART CHARLES SNAVELY M. D.” Practice Location

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