Provider Demographics
NPI:1144387242
Name:SNYDER, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3340 PROVIDENCE DR
Mailing Address - Street 2:457
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4628
Mailing Address - Country:US
Mailing Address - Phone:907-333-8854
Mailing Address - Fax:907-337-3226
Practice Address - Street 1:3340 PROVIDENCE DR
Practice Address - Street 2:457
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4628
Practice Address - Country:US
Practice Address - Phone:907-333-8854
Practice Address - Fax:907-337-3226
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK1131208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1131Medicaid
AKC52056Medicare UPIN
AKMD1131Medicaid