Individual
TIMOTHY MATTHEW SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
915 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1443
(765) 463-2424
(765) 463-2249
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01038504A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000782957
ANTHEM
—
05
—
100101850
—
IN
01
—
10786209
CAQH
—
Enumeration date
04/04/2006
Last updated
09/14/2023
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