Basic Information
| Provider Information | |||||||||
| NPI: | 1437691342 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNYDER | ||||||||
| FirstName: | SAMANTHA | ||||||||
| MiddleName: | ANNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 205 S FRONT ST | ||||||||
| Address2: | GME OFFICE BRADY 9 | ||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041619 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 205 S FRONT ST | ||||||||
| Address2: | GME OFFICE BRADY 9 | ||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041619 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172318506 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2016 | ||||||||
| LastUpdateDate: | 11/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MT212317 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD469253 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.