Individual
DR. BRANDON SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3050 MONTVALE DR, SPRINGFIELD, IL 62704-4290
(217) 726-8096
Mailing address
3050 MONTVALE DR, SPRINGFIELD, IL 62704-4290
(217) 726-8096
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036137127
IL
2085R0202X
Diagnostic Radiology Physician
2015001559
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200022050
—
MO
Enumeration date
06/22/2009
Last updated
12/03/2020
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