Provider Demographics
NPI:1629079710
Name:SNYDER, ART RAY (MD)
Entity Type:Individual
Prefix:
First Name:ART
Middle Name:RAY
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 1:1255 HILLRISE CIR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4741
Mailing Address - Country:US
Mailing Address - Phone:505-532-5934
Mailing Address - Fax:505-522-9047
Practice Address - Street 1:1255 HILLRISE CIR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4741
Practice Address - Country:US
Practice Address - Phone:505-532-5934
Practice Address - Fax:505-522-9047
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM94-147207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM66003395OtherRR MEDICARE
NMS1472Medicaid
NMNM013994OtherBCBS