MEDICARE: DR. JAMES EDWARD SNYDER PH.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	103TC0700X	Clinical Psychologist	0951	NC

General Provider Information

NPI Number	:	1730277443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES EDWARD SNYDER PH.D.

Provider Business Mailing Address
First Line	:	4009 COUNTRY VILLAGE DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27606-9202
Country	:	US
Telephone Number	:	919-859-4903
Fax Number	:	919-515-8525

Provider Business Practice Location Address
First Line	:	7404 CHAPEL HILL RD STE A
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-5043
Country	:	US
Telephone Number	:	919-513-1866
Fax Number	:	919-851-4311

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/08/2007

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