Provider Demographics
NPI:1447209648
Name:SNIDER, ALAN HERBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:HERBERT
Last Name:SNIDER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 E CUMMINS ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286-2070
Mailing Address - Country:US
Mailing Address - Phone:517-423-7425
Mailing Address - Fax:517-423-7870
Practice Address - Street 1:501 E CUMMINS ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286-2070
Practice Address - Country:US
Practice Address - Phone:517-423-7425
Practice Address - Fax:517-423-7870
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS008472207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5749OtherHEALTH PLAN OF MICHIGAN
MI2054613294OtherBCBS OF MI
MI03624OtherPARAMOUNT
MI1763649Medicaid
MI102953OtherGREAT LAKES HEALTH PLAN
MI4515818OtherAETNA
MI502766OtherCARE CHOICES
MI102953OtherGREAT LAKES HEALTH PLAN
MI2054613294OtherBCBS OF MI