Provider Demographics
NPI:1376621482
Name:SNYDER, ALBERT GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:GLENN
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:755 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 231B
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4900
Mailing Address - Country:US
Mailing Address - Phone:248-404-9545
Mailing Address - Fax:248-362-6157
Practice Address - Street 1:755 W BIG BEAVER RD
Practice Address - Street 2:SUITE 231B
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4900
Practice Address - Country:US
Practice Address - Phone:248-404-9545
Practice Address - Fax:248-362-6157
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301045974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F07671Medicare UPIN
OP16910Medicare ID - Type Unspecified