Provider Demographics
NPI:1922005099
Name:SNYDER, KHRISTIAN D (DPM)
Entity Type:Individual
Prefix:DR
First Name:KHRISTIAN
Middle Name:D
Last Name:SNYDER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:798 CHERRY TREE CT
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-7901
Mailing Address - Country:US
Mailing Address - Phone:717-630-8100
Mailing Address - Fax:717-630-2800
Practice Address - Street 1:798 CHERRY TREE COURT
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-7901
Practice Address - Country:US
Practice Address - Phone:717-630-8100
Practice Address - Fax:717-630-2800
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC004467R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1807592Medicaid
PA067342Medicare ID - Type Unspecified
PA1807592Medicaid