Provider Demographics
NPI:1841387305
Name:SNIDER, LLOYD I (OD)
Entity Type:Individual
Prefix:
First Name:LLOYD
Middle Name:I
Last Name:SNIDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4114 W MAPLE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48301
Mailing Address - Country:US
Mailing Address - Phone:248-539-4800
Mailing Address - Fax:248-539-4894
Practice Address - Street 1:4114 W MAPLE RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD TWP
Practice Address - State:MI
Practice Address - Zip Code:48301
Practice Address - Country:US
Practice Address - Phone:248-539-4800
Practice Address - Fax:248-539-4894
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MILS002768152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U23841Medicare UPIN
1051640001Medicare NSC