Basic Information
Provider Information
NPI: 1295831907
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SNYDER
FirstName: DAVID
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 PILLSBURY ST
Address2: SUITE 202
City: CONCORD
State: NH
PostalCode: 033013556
CountryCode: US
TelephoneNumber: 6032244776
FaxNumber: 6032282113
Practice Location
Address1: 1 PILLSBURY ST
Address2: SUITE 202
City: CONCORD
State: NH
PostalCode: 033013556
CountryCode: US
TelephoneNumber: 6032244776
FaxNumber: 6032282113
Other Information
ProviderEnumerationDate: 09/16/2006
LastUpdateDate: 01/11/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X6960NHY Allopathic & Osteopathic PhysiciansAnesthesiology 

ID Information
IDTypeStateIssuerDescription
0000060105NH MEDICAID
0104953Y0NH0201NHANTHEM BCBSOTHER
106501NHCIGNAOTHER


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