Basic Information
| Provider Information | |||||||||
| NPI: | 1427492776 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SNOWBERGER | ||||||||
| FirstName: | CAROLINE | ||||||||
| MiddleName: | KELLY | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 FOULK RD STE 100B | ||||||||
| Address2: | CHRISTIANA CARE HEALTH SYSTEM | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198032764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024773300 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1401 FOULK RD STE 100B | ||||||||
| Address2: | CHRISTIANA CARE HEALTH SYSTEM | ||||||||
| City: | WILMINGTON | ||||||||
| State: | DE | ||||||||
| PostalCode: | 198032764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3024773300 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2013 | ||||||||
| LastUpdateDate: | 07/12/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207Q00000X | C7-0005387 | DE | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.