Provider Demographics
NPI:1033112172
Name:SNYDER, HEATHER S (DPM)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:S
Last Name:SNYDER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 INCARNATION DR
Mailing Address - Street 2:STE 202
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-5708
Mailing Address - Country:US
Mailing Address - Phone:434-979-0728
Mailing Address - Fax:434-979-0730
Practice Address - Street 1:1410 INCARNATION DR
Practice Address - Street 2:STE 202
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-5708
Practice Address - Country:US
Practice Address - Phone:434-979-0728
Practice Address - Fax:434-979-0730
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001052213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA291476OtherMAMSI
VA541937173OtherSOUTHERN HEALTH/ TRICARE
VA283946OtherANTHEM BCBS
VA1895709OtherFIRST HEALTH
VA9300678Medicaid
VA700026073OtherCIGNA
VA700026073OtherCIGNA
VA541937173OtherSOUTHERN HEALTH/ TRICARE
VAU75625Medicare UPIN
VA480000632Medicare PIN