Provider Demographics
NPI:1457652943
Name:SNOW, RICHARD JOHN (DO)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOHN
Last Name:SNOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:933 S TALBOT ST STE 4
Mailing Address - Street 2:
Mailing Address - City:ST MICHAELS
Mailing Address - State:MD
Mailing Address - Zip Code:21663-2605
Mailing Address - Country:US
Mailing Address - Phone:107-450-2004
Mailing Address - Fax:339-082-2818
Practice Address - Street 1:933 S. TALBOT ST
Practice Address - Street 2:UNIT 4
Practice Address - City:ST. MICHAELS
Practice Address - State:MD
Practice Address - Zip Code:21663-2633
Practice Address - Country:US
Practice Address - Phone:410-745-0200
Practice Address - Fax:833-908-2281
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-003742207Q00000X
MDH0038590207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHE00707Medicare UPIN