Provider Demographics
NPI:1790824258
Name:SNYDER, BERNARD MELVIN (MD)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:MELVIN
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 1:11125 ROCKVILLE PIKE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852
Mailing Address - Country:US
Mailing Address - Phone:301-881-7554
Mailing Address - Fax:301-230-2943
Practice Address - Street 1:11125 ROCKVILLE PIKE
Practice Address - Street 2:SUITE 206
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-881-7554
Practice Address - Fax:301-230-2943
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00017372084P0800X
VA01010189002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C62381Medicare UPIN