Provider Demographics
NPI:1982936142
Name:SNYDER, PAUL JOSEPH (RPH)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JOSEPH
Last Name:SNYDER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:PAUL
Other - Middle Name:JOSEPH
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:G3083 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1353
Mailing Address - Country:US
Mailing Address - Phone:810-238-0489
Mailing Address - Fax:810-235-8118
Practice Address - Street 1:G3083 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1353
Practice Address - Country:US
Practice Address - Phone:810-238-0489
Practice Address - Fax:810-235-8118
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302021367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist