Provider Demographics
NPI:1497725352
Name:SNUFFER, ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:SNUFFER
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 1:402 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-1678
Mailing Address - Country:US
Mailing Address - Phone:304-269-3929
Mailing Address - Fax:304-269-3911
Practice Address - Street 1:402 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-1678
Practice Address - Country:US
Practice Address - Phone:304-269-3929
Practice Address - Fax:304-269-3911
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1962207P00000X
WVWV1962207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1808763000Medicaid
WV1808763000Medicaid