Organization
MARK A SNIDER MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE WEBBER CMRS (BILLING AGENT)
(734) 242-0400
Entity
Organization
Contact information
Practice address
905 N MACOMB ST, STE 4, MONROE, MI 48162-3075
(734) 242-6161
(734) 242-0401
Mailing address
905 N MACOMB ST, STE 4, MONROE, MI 48162-3075
(734) 242-6161
(734) 243-6644
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301060460
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0581120
BLUE CROSS BLUE SHIELD
MI
01
—
DP9638
PALMETTO GBA - RR MEDICARE
MI
Enumeration date
10/07/2008
Last updated
10/13/2014
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