Provider Demographics
NPI:1831188630
Name:SNYDER, MICHEL A (MD)
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:A
Last Name:SNYDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:608 S 9TH ST
Mailing Address - Street 2:STE C
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6342
Mailing Address - Country:US
Mailing Address - Phone:352-787-4532
Mailing Address - Fax:352-787-0498
Practice Address - Street 1:608 S 9TH ST
Practice Address - Street 2:STE C
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6342
Practice Address - Country:US
Practice Address - Phone:352-787-4532
Practice Address - Fax:352-787-0498
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-14
Last Update Date:2010-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL0037050207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35171Medicare ID - Type Unspecified
D54346Medicare UPIN