Provider Demographics
NPI:1568692861
Name:H.L. SNYDER, D.P.M.
Entity Type:Organization
Organization Name:H.L. SNYDER, D.P.M.
Other - Org Name:LISLE NNYDER, HERMAN LISLE SNYDER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HERMAN
Authorized Official - Middle Name:LISLE
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:828-262-1808
Mailing Address - Street 1:2211 HWY. 105 SOUTH
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-262-1808
Mailing Address - Fax:828-262-0204
Practice Address - Street 1:2211 HWY. 105 SOUTH
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-262-1808
Practice Address - Fax:828-262-0204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08169OtherBCBS
NC8908169Medicaid
NC243037Medicare PIN