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Individual

MARK SNIADANKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2600 NAVARRE AVE, OREGON, OH 43616-3207
(419) 696-7500
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-3014

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
34-008693
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000522688
BCBS ST CHARLES
OH
05
2782743
OH
01
P00435623
RRN MCR ST CHARLES
OH
Enumeration date
06/20/2007
Last updated
10/16/2008
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