Individual
STACY L SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
615 N MICHIGAN ST 4TH FL, SOUTH BEND, IN 46601-1033
(574) 647-6892
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
01082192A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300026335
—
IN
Enumeration date
03/29/2013
Last updated
05/01/2023
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