Provider Demographics
NPI:1760818058
Name:SNYDER, ADAM BRIAN
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:BRIAN
Last Name:SNYDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2206
Mailing Address - Country:US
Mailing Address - Phone:614-560-0123
Mailing Address - Fax:614-442-4690
Practice Address - Street 1:2724 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:BEXLEY
Practice Address - State:OH
Practice Address - Zip Code:43209-2206
Practice Address - Country:US
Practice Address - Phone:614-560-0123
Practice Address - Fax:614-442-4690
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58642251X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251X00000XAgenciesSupports Brokerage