Provider Demographics
NPI:1700847670
Name:SNOOK, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:SNOOK
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 1:5 NEPONSET ST FL STREET12
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-2714
Mailing Address - Country:US
Mailing Address - Phone:508-595-2655
Mailing Address - Fax:508-425-5220
Practice Address - Street 1:5 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-2714
Practice Address - Country:US
Practice Address - Phone:508-595-2655
Practice Address - Fax:508-425-5220
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA74595207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
784086OtherMVP HEALTH CARE
J12081OtherBLUE CARE ELECT
J12081OtherBLUE SHIELD HMO BLUE
J12081OtherMEDICARE B
042472266OtherHEALTHCARE VALUE MANAGEME
MA3100545Medicaid
0300126OtherEVERCARE
042472266OtherONE HEALTH PLAN
7852920OtherCIGNA HEALTH PLAN
J12081OtherBLUE SHIELD INDEMNITY
042472266OtherPRIVATE HEALTHCARE SYSTEM
1061446OtherFIRST HEALTH
33316OtherCHILDRENS MEDICAL SECURIT
AA4386OtherHARVARD PILGRIM HEALTHCAR
3100545OtherMEDICAID WELFARE
33316OtherHEALTHY START
5844188OtherAETNA US HEALTHCARE
9900848OtherFALLON COMMUNITY HEALTH P
J12081OtherBLUE CARE ELECT
33316OtherCHILDRENS MEDICAL SECURIT