Provider Demographics
NPI:1376546408
Name:SNYDER, BRYAN RICHARD (DPM)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:RICHARD
Last Name:SNYDER
Suffix:
Gender:M
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:SUITE 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:SUITE 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:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001051213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA265249OtherANTHEM BCBS
VA541937173OtherSOUTHERN HEALTH/ TRICARE
VA9300554Medicaid
VA700026072OtherCIGNA
VA1904238OtherFIRST HEALTH
VA291473OtherMAMSI
VA480000631Medicare PIN
VA265249OtherANTHEM BCBS
VA700026072OtherCIGNA
VA1904238OtherFIRST HEALTH