MEDICARE: EDWARD D SNELL 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	207QS0010X	Sports Medicine (Family Medicine) Physician	MD050617L	PA
2	207Q00000X	Family Medicine Physician	MD050617L	PA

General Provider Information

NPI Number	:	1598763229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD D SNELL MD

Provider Business Mailing Address
First Line	:	1307 FEDERAL ST STE 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-4769
Country	:	US
Telephone Number	:	877-660-6777
Fax Number	:	412-359-8055

Provider Business Practice Location Address
First Line	:	1307 FEDERAL ST STE 2
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-4769
Country	:	US
Telephone Number	:	877-660-6777
Fax Number	:	412-359-8055

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	10/06/2020

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Directions to “ EDWARD D SNELL MD” Practice Location

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