Provider Demographics
NPI:1063679058
Name:ROBERT SNUFFER, DO
Entity Type:Organization
Organization Name:ROBERT SNUFFER, DO
Other - Org Name:WESTON FAMILY MEDICAL CARE, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SNUFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-269-3929
Mailing Address - Street 1:402 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-1678
Mailing Address - Country:US
Mailing Address - Phone:304-269-3929
Mailing Address - Fax:304-269-3911
Practice Address - Street 1:402 MEDICAL PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-1678
Practice Address - Country:US
Practice Address - Phone:304-269-3929
Practice Address - Fax:304-269-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1808763000Medicaid
RO9352031Medicare PIN