Provider Demographics
NPI:1952420275
Name:SNYDER, TERENCE G (MD)
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:G
Last Name:SNYDER
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 1:103 FOX ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-2523
Mailing Address - Country:US
Mailing Address - Phone:910-622-1301
Mailing Address - Fax:
Practice Address - Street 1:913 CAROLINA AVE. N.
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677
Practice Address - Country:US
Practice Address - Phone:704-871-0937
Practice Address - Fax:704-871-9419
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95-007282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC897835MMedicaid