Provider Demographics
NPI:1649355827
Name:SNODDY, BRIAN D (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:D
Last Name:SNODDY
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 1:100 PILOT MEDICAL DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3404
Mailing Address - Country:US
Mailing Address - Phone:205-856-2284
Mailing Address - Fax:205-815-4777
Practice Address - Street 1:100 PILOT MEDICAL DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3404
Practice Address - Country:US
Practice Address - Phone:205-856-2284
Practice Address - Fax:205-815-4777
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00018231174400000X
AL18231207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009982000Medicaid
AL51505310OtherBCBS
AL110233856OtherRRMC
AL4851219OtherCIGNA
AL2500303OtherUNITED HEALTHCARE
AL051505310Medicare PIN
AL009982000Medicaid