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NPI Code Detail

MEDICARE: JONATHAN R. SNYDER MD

MEDICARE: JONATHAN R. SNYDER MD
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
1207R00000XInternal Medicine Physician2012-01245NC
2208000000XPediatrics Physician259989MA
3208000000XPediatrics Physician2012-01245NC
4207R00000XInternal Medicine Physician259989MA

General Provider Information

NPI Number : 1326243775
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN R. SNYDER MD
Provider Business Mailing Address
First Line : 2 CORPORATION WAY
Second Line :
City : PEABODY
State : MA
Zip : 01960-7932
Country : US
Telephone Number : 978-573-4378
Fax Number :
Provider Business Practice Location Address
First Line : 100 CUMMINGS CTR STE 136P
Second Line :
City : BEVERLY
State : MA
Zip : 01915-6127
Country : US
Telephone Number : 978-279-0800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2007
Last Update Date : 11/19/2020

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