MEDICARE: MARCUS HILTON SNOW 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
1	207R00000X	Internal Medicine Physician	22989	NE
2	208000000X	Pediatrics Physician	22989	NE
3	207RR0500X	Rheumatology Physician	22989	NE

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	89-00075	OTHER	NE	UHC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588685127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS HILTON SNOW MD

Provider Business Mailing Address
First Line	:	110 N 175TH ST
Second Line	:	SUITE 2000
City	:	OMAHA
State	:	NE
Zip	:	68118-3582
Country	:	US
Telephone Number	:	402-596-4411
Fax Number	:	402-596-4432

Provider Business Practice Location Address
First Line	:	110 N 175TH ST
Second Line	:	SUITE 2000
City	:	OMAHA
State	:	NE
Zip	:	68118-3582
Country	:	US
Telephone Number	:	402-596-4411
Fax Number	:	402-596-4432

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/17/2015

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Directions to “ MARCUS HILTON SNOW MD” Practice Location

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