Provider Demographics
NPI:1720018682
Name:SNYDER, MATTHEW L (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
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 418837
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8837
Mailing Address - Country:US
Mailing Address - Phone:888-846-5527
Mailing Address - Fax:607-324-2369
Practice Address - Street 1:4901 TELSA DR
Practice Address - Street 2:SUITE A & B
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4406
Practice Address - Country:US
Practice Address - Phone:301-805-6860
Practice Address - Fax:301-805-0755
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00510222085R0001X
DCMD302132085R0001X
DEC1-00043422085R0001X
VA01010501982085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD210940OtherMAMSI
MD2130465 04OtherUNITED HC/AMERICHOICE
DC29020007OtherCAREFIRST BC/BS
MD90296OtherAMERIGROUP
DC034432500Medicaid
MD1728655OtherFIRST HEALTH/CCN
MD9059699OtherPHCS
MD2257233OtherAETNA HMO
MD7475033OtherAETNA PPO/POS
MD2937104002OtherCIGNA
DC497792OtherNATIONAL CAPITOL PPO
MD603327-03OtherCAREFIRST BC/BS
MD112507900Medicaid
MD4582OtherELDER HEALTH
MD12665OtherJOHNS HOPKINS HEALTHCARE
MD202365OtherKAISER PERMANENTE
MD1728655OtherFIRST HEALTH/CCN
MD2937104002OtherCIGNA
DC034432500Medicaid
MD920004784Medicare PIN