Provider Demographics
NPI:1568433928
Name:SNYDER, DIEHL M (MD)
Entity Type:Individual
Prefix:
First Name:DIEHL
Middle Name:M
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-1625
Mailing Address - Country:US
Mailing Address - Phone:207-288-5081
Mailing Address - Fax:207-288-8600
Practice Address - Street 1:322 MAIN ST
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-1648
Practice Address - Country:US
Practice Address - Phone:207-288-5081
Practice Address - Fax:207-288-8600
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2017-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD161962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME412490099Medicaid
MEMD16196OtherMAINE LICENSE
ME412490099Medicaid
MERX3774Medicare PIN