Provider Demographics
NPI:1275502320
Name:SNYDER, ALEXANDER B (MD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:B
Last Name:SNYDER
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 1:1420 E FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-5160
Mailing Address - Country:US
Mailing Address - Phone:704-289-8427
Mailing Address - Fax:
Practice Address - Street 1:3369 CLINGMAN RD
Practice Address - Street 2:
Practice Address - City:RONDA
Practice Address - State:NC
Practice Address - Zip Code:28670-8708
Practice Address - Country:US
Practice Address - Phone:336-984-3003
Practice Address - Fax:336-984-2700
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:2006-12-27
Deactivation Code:
Reactivation Date:2007-05-22
Provider Licenses
StateLicense IDTaxonomies
NC18575207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8978362Medicaid
NC201513AMedicare ID - Type Unspecified
E00424Medicare UPIN