Provider Demographics
NPI:1750598454
Name:DANIEL E. SNOW, M.D., GAITHERSBURG FAMILY PRACITCE, PC
Entity type:Organization
Organization Name:DANIEL E. SNOW, M.D., GAITHERSBURG FAMILY PRACITCE, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-251-9503
Mailing Address - Street 1:15001 DUFIEF MILL RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878-2599
Mailing Address - Country:US
Mailing Address - Phone:301-251-9503
Mailing Address - Fax:
Practice Address - Street 1:15001 DUFIEF MILL RD
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878-2599
Practice Address - Country:US
Practice Address - Phone:301-251-9503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045533207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD118801100Medicaid
MD118801100Medicaid
DCG00680Medicare PIN