MEDICARE: STEVEN CHARLES SNYDER

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	174400000X	Specialist
2	174H00000X	Health Educator

General Provider Information

NPI Number	:	1235751116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN CHARLES SNYDER

Provider Business Mailing Address
First Line	:	PO BOX 55
Second Line	:
City	:	SPRING MILLS
State	:	PA
Zip	:	16875-0055
Country	:	US
Telephone Number	:	814-422-8800
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 BOYD HOLLOW LN
Second Line	:
City	:	SPRING MILLS
State	:	PA
Zip	:	16875-7812
Country	:	US
Telephone Number	:	814-422-8800
Fax Number	:

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

Provider Enumeration Date	:	05/13/2020
Last Update Date	:	05/13/2020

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