Provider Demographics
NPI:1457302853
Name:SNYDER, KENNETH L (DO)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:SNYDER
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 1:15 HOSPITAL CENTER COMMON
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2727
Mailing Address - Country:US
Mailing Address - Phone:843-682-2800
Mailing Address - Fax:843-682-2786
Practice Address - Street 1:15 HOSPITAL CENTER COMMON
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2727
Practice Address - Country:US
Practice Address - Phone:843-682-2800
Practice Address - Fax:843-682-2786
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC959207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA13357094Medicare PIN
SCAA13356768Medicare PIN
SCI53094Medicare UPIN