Provider Demographics
NPI:1447369590
Name:SNYDER, ROBERT CRAVEN JR (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CRAVEN
Last Name:SNYDER
Suffix:JR
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 1:2508 PELHAM PKWY
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-1321
Mailing Address - Country:US
Mailing Address - Phone:205-664-0880
Mailing Address - Fax:205-664-0895
Practice Address - Street 1:2508 PELHAM PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-1321
Practice Address - Country:US
Practice Address - Phone:205-664-0880
Practice Address - Fax:205-664-0895
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00012143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC72818Medicare UPIN