MEDICARE: DR. BRYAN RICHARD SNYDER D.P.M.

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	213EP1101X	Primary Podiatric Medicine Podiatrist	0103001051	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	265249	OTHER	VA	ANTHEM BCBS
2	541937173	OTHER	VA	SOUTHERN HEALTH/ TRICARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	700026072	OTHER	VA	CIGNA
5	1904238	OTHER	VA	FIRST HEALTH
6	291473	OTHER	VA	MAMSI

General Provider Information

NPI Number	:	1376546408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRYAN RICHARD SNYDER D.P.M.

Provider Business Mailing Address
First Line	:	1410 INCARNATION DR
Second Line	:	SUITE 202
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-5708
Country	:	US
Telephone Number	:	434-979-0728
Fax Number	:	434-979-0730

Provider Business Practice Location Address
First Line	:	1410 INCARNATION DR
Second Line	:	SUITE 202
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-5708
Country	:	US
Telephone Number	:	434-979-0728
Fax Number	:	434-979-0730

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/11/2023

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Directions to “ DR. BRYAN RICHARD SNYDER D.P.M.” Practice Location

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