Provider Demographics
NPI:1235426685
Name:SNIDER, ALICIA ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:ELIZABETH
Last Name:SNIDER
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24 FRANK LLOYD WRIGHT DRIVE
Mailing Address - Street 2:SUITE J2000
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-747-6766
Mailing Address - Fax:734-222-3100
Practice Address - Street 1:IHA GENERAL SURGERY
Practice Address - Street 2:14650 E OLD US HIGHWAY 12 SUITE 303
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118
Practice Address - Country:US
Practice Address - Phone:734-475-4177
Practice Address - Fax:734-475-3520
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301110078208600000X
OH35.140685208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0421934Medicaid