Basic Information
| Provider Information | |||||||||
| NPI: | 1073714465 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SNIPE | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | JANEEN-BELTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 319 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291504258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037746448 | ||||||||
| FaxNumber: | 8037748299 | ||||||||
| Practice Location | |||||||||
| Address1: | 319 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SUMTER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 291504258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8037746448 | ||||||||
| FaxNumber: | 8037748299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2007 | ||||||||
| LastUpdateDate: | 09/04/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 200801814 | NC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 331698 | 05 | SC | MEDICAID |