Provider Demographics
NPI:1669516035
Name:SNYDER, DANAL SUE (MD)
Entity type:Individual
Prefix:DR
First Name:DANAL
Middle Name:SUE
Last Name:SNYDER
Suffix:
Gender:F
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:PO BOX 1267
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:NC
Mailing Address - Zip Code:27030-1267
Mailing Address - Country:US
Mailing Address - Phone:336-719-7000
Mailing Address - Fax:
Practice Address - Street 1:280 N POINTE BLVD
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030-2267
Practice Address - Country:US
Practice Address - Phone:336-786-4133
Practice Address - Fax:336-783-3417
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00044207Q00000X
CODR.0054938207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC45526EMedicare UPIN