Provider Demographics
NPI:1083671697
Name:SNODDY, WILLIAM R (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:SNODDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 BEAR LEFT
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-8208
Mailing Address - Country:US
Mailing Address - Phone:828-252-8154
Mailing Address - Fax:
Practice Address - Street 1:41 OAKLAND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4820
Practice Address - Country:US
Practice Address - Phone:828-252-8885
Practice Address - Fax:828-252-9420
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21606207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC210563Medicare PIN
NCC86525Medicare UPIN