MEDICARE: DR. ALBERT GLENN 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
1	207R00000X	Internal Medicine Physician	4301045974	MI

General Provider Information

NPI Number	:	1376621482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT GLENN SNYDER M.D.

Provider Business Mailing Address
First Line	:	755 W BIG BEAVER RD
Second Line	:	SUITE 231B
City	:	TROY
State	:	MI
Zip	:	48084-4900
Country	:	US
Telephone Number	:	248-404-9545
Fax Number	:	248-362-6157

Provider Business Practice Location Address
First Line	:	755 W BIG BEAVER RD
Second Line	:	SUITE 231B
City	:	TROY
State	:	MI
Zip	:	48084-4900
Country	:	US
Telephone Number	:	248-404-9545
Fax Number	:	248-362-6157

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

Provider Enumeration Date	:	11/02/2006
Last Update Date	:	07/08/2007

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