Individual
NICOLAS SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2640 W BASELINE RD, PHOENIX, AZ 85041-6492
(480) 677-8282
(480) 677-8283
Mailing address
4600 S MILL AVE, TEMPE, AZ 85282-6757
(480) 305-2888
(480) 305-2889
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
4749
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
624191
—
AZ
Enumeration date
10/21/2010
Last updated
07/23/2015
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